Implant Survival in Tissue-Engineered Mandibular Reconstruction-Early Experiences

Purpose: The purpose of this article is to evaluate the early outcomes of dental implants placed in bone generated with tissue engineering techniques, specifically recombinant human bone morphogenic protein-2 (rhBMP-2), allogeneic bone particulate, and bone marrow aspirate concentrate (BMAC) in patients with resection of benign pathology. Methods: We retrospectively evaluated 12 patient records, all of whom underwent segmental mandibular resection of benign pathology and reconstruction with a combination of BMAC, rhBMP-2, and allogeneic bone. Collected data points included the patient's age, gender, medical and social histories, implant site and placement date, resection/reconstruction date, final prosthesis, pathology resected, and follow-up dates (average 25 months of follow-up). Implant success was defined as clinical osseointegration (immobility), absence of peri-implant radiolucency, and absence of infection. Results: Twelve patients met inclusion criteria with a total 46 implants. The overall implant survival rate was 91.3%. There were 4 implant failures occurring in two patients: 1 failure in Patient 3 and 3 failures in Patient 8. Neither patient had any existing medical comorbidities or social history known to increase the risk for implant failure. The average implant placement occurred 11.6 months after mandibular reconstruction. Conclusion: Preliminary findings of implant placement in bone generated with tissue engineering techniques have shown to be another predictable alternative for orofacial rehabilitation. Practical Implications: Dental rehabilitation using dental implants is a predictable treatment option for patients that have required reconstruction of large bony defects status post resection of benign pathology using novel tissue engineering techniques.