Autoinjerto óseo esterilizado y reconstituido con médula ósea autóloga: Una alternativa de reconstrucción mandibular

Abstract

Mandible reconstruction is a significant problem due to limitations in relation with availability of bone grafts and dismal esthetic and functional results with microvascular flaps. We carried out a pilot study in order to explore the feasibility of bone reconstruction recycling the same excised bone reconstituted with autologous bone marrow and particulated bone. Three dogs were submitted to surgery in order to resect a mandibular fragment of 6 cm. This bone was autoclaved for 40 min. Then bone was drilled with 3 mm holes every 10 mm. The holes were packed with autologous bone marrow from iliac bone and particulated bone without anticoagulants. Reconstituted bone was implanted over latissimus dorsi muscle. Wound were closed with vycril 000 Four weeks after, dogs were submitted to bone marrow scintigram with 5 mCi of colloidal rhenium. The scan showed radionuclide uptake, probing viability. One hour later, bone was excised in two of them and histopathologic study corroborated de bone marrow viability. Eight weeks later the third dog was submitted to a bone scintigram with MDP-Tc 99 that probed the generation of new bone Mandibular bone autograph is associated with bone viability and means the possibility of an easy reconstruction of large bone defects including mandibular segments. This would conduct to better treatment with wider resections and enhanced local control without preoccupations in relationship to esthetic and functional sequels.