1.Bone augmentation by means of grafts derived from
culture and growth of human stem cells may represent a fast and
effective solution to allow implantology in atrophied jaws.
2.Micro-vascularized free-flaps obtain a reconstruction of both
hard and soft tissues ablated for being affected by tumors; they
may be molded to resemble the resected portion of the affected
jaws, recovering their previous morphology and function. 3. In
sinus lift procedure, synthetic osteoconductive biomaterials
demonstrated to be effective as scaffold for the bone formation
starting from the host place.4. Surgical treatment of neoplastic
pathologies of the maxillo-facial complex. 5. Histological
assessment of regenerated bone using a mix of autologous bone and
osteoconductive material or osteoconductive material alone below a
titanium mesh.
Bone reconstruction after a remarkable bone loss
due to huge
facial trauma, severe atrophies, or wide resection for benign or
malign tumor ablation results an essential phase for the recover of
the patient physiognomy . Obtaining an adequate bone height and
thickness by means of grafts from human stem cells culture and /or
osteoconductive bone substitutes may be considered a fast and
effective alternative solution to allow implant placement. This new
therapeutic approach makes faster the accomplishment of a
successful implant-borne prosthetic rehabilitation, enabling
patient to recover a good chewing and aesthetical function within
six months, notably reducing infection risk and post-surgery
discomfort and pain.
2. The free-flaps achievement entails the recover of a
vascular pedicle subsequent anastomized with micro-surgery to
vessels of the neck and face, previously identified.
Micro-vascularized free-flaps allow a recovery of both hard and
soft tissues, and may be shaped to resemble the resected portion of
the affected jaws. Most frequently these reconstructive procedures
are applied during or subsequently to oncologic oral-maxillo-facial
surgeries with the aim of completely removing the tumor and, at the
same time, repairing tissue loss, that extremely impairs oral
functions, such as chewing, swallowing and speaking . This
technique limit the great problems related to ablation of essential
organs such as the tongue, the mandible, the nose
pyramid.
The use of stereolytographics models from the
three-dimensional TC reconstruction , precisely reproducing the
anatomical situation of the patient jaws, enable us to correctly
study the caseto be treated and to mould pre-operatively the
ostesyntetic plates needed, reducing the surgical timing and the
complication rate.
3. The surgical procedure of great sinus lift entails
the lift of sinusal membrane and the application below of different
kind of bone grafts mixed with biomaterials, to allow mineralized
tissue to be created for implant placement. Autologous bone is up
to date the gold standard material for its own reliability and
osteogenic, osteoinductive and osteoconductive features. Different
osteoconductive biomaterials, reported in literature, seem to be
useful substitutes of autologous bone when mixed with it. These
materials, deeply studied in the last years, although provided of
just osteoconductive features and prone to a slow resoption
process, revealed themselves to be very effective as scaffold for
the invasion of autologous bone cells from the recipient
site.
4. Reduction of relapse percentage and widening of
5 years survival are the goals of our studies about oncologic
issue. A well-timed diagnosis and the identification of oncogenic
markers are the end-points of the research project at point
5.
Titanium meshes have been used for the first time
by Von Arx in 1996 for pre-implantological bone reconstruction. Some
studies, published in the last years, reported a a high percentage
of success with this technique. The aim of our project about this
issue is the assessment of the real correspondence between
stereolithographic model and the clinical situation of the patient,
verifying the reduction of surgical timing, and the lowering of
complication rate.
In the test group the mesh will be moulded
pre-operatively on stereolythographic models obtained from TC three-dimensional
reconstruction , while, in the control group, the meshs will be
moulded intra-operatively, according to standard protocol .
Furthermore, it'll be evaluated the effectiveness of a mix of
autologous bone and biomaterials respect to biomaterial alone below
a titanium mesh in terms of quantity and histological quality of
regenerated bone in atrophied ridges .
