Early Radiological Limitations in Bone Healing Estimation After Allogeneic Bone Grafts Used for Mandible Reconstruction

TL;DR

This paper discusses the challenges of early radiological assessment of bone healing after using allogeneic bone grafts for mandible reconstruction.

Contribution

The paper highlights the limitations of early radiological evaluation in detecting bone healing and complications after allogeneic bone grafts.

Findings

Early radiological evaluation may not accurately reflect bone healing progress.

Bone inflammation and radiolucent defects can be signs of graft complications.

Wound dehiscence and graft exposure may require additional surgical interventions.

Abstract

Xenograft bone, autologous bone grafts or allogeneic bones from a bone bank are used for bone augmentation, reconstruction or other purposes, when the volume, shape, and size of each jawbone defect require different bone materials. In the case of some bigger and locally advanced bone defects, the use of allogeneic bone can be suitable and used with great success if the wound and bone are especially carefully maintained; however, the healing period of each bone depends on good and stable wound closure followed by improved local antiseptic protocol. The individuality of each bone defect might also require additional prophylactic titanium plating in order to decrease the risk of possible mandibular fracture or to help improve bone stability, reduce bone mobility and possible inflammation or granulation tissue formation. Early radiological estimation of bone healing evaluation might be troublesome and not fully visible in radiological evaluation in the early stages of bone healing. On the other hand, possible bone inflammation, radiolucent defects, and granulation formation could be noted in cases of acute or long-lasting bone grafting material inflammation, bacterial contamination within the bone defect area, or the presence of fistula. The presented case describes a very good outcome from a dentigerous cyst removal with bone defect grafting and plating; however, because of wound dehiscence and allogeneic bone graft exposure, the patient required one additional procedure.

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