Bilateral orbitozygomatic reconstruction with tissue-engineered bone.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Critical defects of the craniomaxillofacial region and long bones are often treated with bone grafts and vascularized osteocutaneous free flaps. These lengthy operations may be associated with considerable donor site morbidity and often have suboptimal functional and aesthetic results. The allure of providing an exact replica of a missing bone that incorporates to become indistinguishable from self, has the capacity to heal and grow, is resistant to infection, and with minimal morbidity is a "holy grail" to all surgeons who work with bone. This is a report of a 14-year-old adolescent boy with Treacher Collins syndrome whose bilateral orbitozygomatic defects were treated with engineered bone made from a combination of human bone allograft, adipose-derived mesenchymal stem cells, bone morphogenic protein-2, and periosteal grafts. This single-stage reconstruction was followed by an exuberant amount of postoperative swelling that persisted for 3 weeks. He had slight lid malposition postoperatively as well but has had no long-term negative effects from the surgery. His reconstruction has remained stable during a 6-month follow-up, and a recent biopsy of the engineered bone demonstrated healthy, lamellar bone. These data are the first to demonstrate revitalization of large volume allograft bone in humans and have positive implications for craniofacial bone tissue engineering. The com

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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