Bone Resorption Clinical Trial
Official title:
Innervation of Vascularized Iliac Transplant Avoids Resorption in Jaw Bone Reconstruction: a Prospective Comparative Clinical Study
The purpose of this study is to determine the efficacy of simultaneous innervation to prevent graft bone resorption in maxillofacial reconstruction. It may provide basis for future clinical trials and new strategies for improving the functional reconstruction of large jaw bone defects.
The use of autograft is still the main method for reconstructing large defects of jaw bones.
However, the spontaneous resorption of the graft bone is still severe, and hinders the
success of dental implant(s) and chewing function even after microsurgical vascularization.
But till now, there is no effective prevention method for this major problem. Based on
previous studies, the investigators pioneered a simultaneous innervated vascularized iliac
bone graft method, through neurorrhaphy between the nerves innervating iliac bone and
recipient site. A clinical retrospective study showed that this new method significantly
decreases postoperative osteoporosis, and ensures the success of dental implants (Refer to
our published article Wang L*, Wei J, Yang X, Yang Z, Sun M, Cheng X, Xu L, Lei D, Zhang C*.
Preventing early-stage graft bone resorption by simultaneous innervation: innervated iliac
bone flap for mandibular reconstruction. PlastIc Reconstructive Surgery, 2017,
139(5):1152e-1161e, Cover Featured Article).
The investigators intend to randomly divide the vascularized iliac bone graft cases into
traditional group without innervation and simultaneous innervation group (through
neurorrhaphy between the nerves innervating iliac bone flap and recipient site). The efficacy
of simultaneously innervated maxillofacial reconstruction for preventing graft bone
resorption will be assessed using bone mineral density test of grafted bone, as a blinded
method. The innervation and sensation of the internal oblique abdominis muscle island will be
tested using neuroelectrophysiological examination. The recipient nerve having the best
effect on preventing bone resorption, will be determined using hierarchical comparison
method.
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