Tissue-engineered oral mucosa grafts for intraoral lining reconstruction of the maxilla and mandible with a fibula flap

J Oral Maxillofac Surg. 2015 Jan;73(1):195.e1-16. doi: 10.1016/j.joms.2014.09.001. Epub 2014 Sep 16.

Abstract

Purpose: Many types of soft tissue grafts have been used for grafting or prelaminating bone flaps for intraoral lining reconstruction. The best results are achieved when prelaminating free flaps with mucosal grafts. We suggest a new approach to obtain keratinized mucosa over a fibula flap using full-thickness, engineered, autologous oral mucosa.

Patients and methods: We report on a pilot study for grafting fibula flaps for mandibular and maxilla reconstruction with full-thickness tissue-engineered autologous oral mucosa. We describe 2 different techniques: prelaminating the fibula flap and second-stage grafting of the fibula after mandibular reconstruction. Preparation of the full-thickness tissue-engineered oral mucosa is also described.

Results: The clinical outcome of the tissue-engineered intraoral lining reconstruction and response after implant placement are reported. A peri-implant granulation tissue response was not observed when prelaminating the fibula, and little response was observed when intraoral grafting was performed.

Conclusion: Tissue engineering represents an alternative method by which to obtain sufficient autologous tissue for reconstructing mucosal oral defects. The full-thickness engineered autologous oral mucosa offers definite advantages in terms of reconstruction planning, donor site morbidity, and quality of the intraoral soft tissue reconstruction, thereby restoring native tissue and avoiding peri-implant tissue complications.

Publication types

  • Case Reports

MeSH terms

  • Alveolar Ridge Augmentation / methods
  • Autografts / transplantation
  • Bone Transplantation / methods*
  • Carcinoma, Mucoepidermoid / surgery
  • Cell Culture Techniques
  • Dental Implantation, Endosseous / methods
  • Female
  • Fibroblasts / physiology
  • Fibula / transplantation
  • Follow-Up Studies
  • Free Tissue Flaps / transplantation*
  • Humans
  • Jaw, Edentulous / surgery
  • Keratinocytes / physiology
  • Male
  • Mandible / surgery*
  • Mandibular Neoplasms / surgery
  • Maxilla / surgery*
  • Middle Aged
  • Mouth Mucosa / cytology
  • Mouth Mucosa / transplantation*
  • Pilot Projects
  • Reconstructive Surgical Procedures / methods*
  • Tissue Engineering / methods*
  • Tissue Scaffolds
  • Treatment Outcome