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Title: The use of an induced muscle flap to reconstruct mandibular defects
Author: Al-Fotawi, Randa
ISNI:       0000 0004 5349 1181
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 2014
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The treatment of challenging large osseous defects presents a formidable problem for orthopaedic and maxillofacial surgeons. Autogenous bone grafting is the present method of choice to replace the lost tissue, but supplies of autologous bone are limited and harvesting of the graft is associated with donor site morbidity. Artificial biomaterials hold much promise, but do not, by themselves, supply the osteoprogenitor cells needed for bone formation. Moreover, there are often issues with resorption of the scaffold used in the biomaterial, as well as limited vascularity. This study investigates the novel application of a composite bone mineral (Cerament TM Spine Support) as an injectable bone cement loaded with cytokines and seeded with induced mesenchymal stromal cells, for maxillofacial reconstruction in rabbits. This study aims to test the feasibility of converting a pedicled muscle flap into bone to reconstruct a critical-size defect in the mandible as the above three components would theoretically have the combined effect of osteoconduction, osteoinduction and osteogenesis. The study included a comprehensive assessment of bone regeneration using plain radiography, Cone Beam computerized Tomography (CBCT), Micro-Computerized Tomography (micro-CT) and histology. Results at 3 months following surgery showed areas of bone formation and remnants of residual cement throughout the muscle and connective tissue in the surgical defect. Data analysis showed that complete bone integration or incorporation for the reconstruction of the surgical defect was not achieved. However, the regenerated bone displayed a high degree of remodeling with an intricate network of woven bone trabeculae within the cement. The bone was thicker in the bucco-lingual direction and exhibited more red and fatty marrow spaces compared to the contralateral (non-operated) side. The study confirmed that bone formation within a muscle flap in the maxillofacial region is possible. However, a wide range of variation in the patterns of bone formation was seen among the samples. The findings demonstrated the remarkable potential for the use of autologous muscle flaps as bioreactors for injectable scaffoldings, BMP, rMSCs to facilitate the reconstruction of maxillofacial bony defects.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: R Medicine (General) ; RK Dentistry