Reconstruction procedures of jaw bones by using reimplantation of resected jaw portion treated by freezing and warming.

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In order to reconstruct the perfect shape of jaw bones, we developed the new operation procedures by using reimplantation of resected jaw portion treated by freezing and warming. The operation procedures which we developed are as follows. One is the one-stage procedure in which immediate reconstruction is performed intraorally, indicated for benign tumors and tumorlike conditions. The other is the two-stage procedure in which late reconstruction is performed extraorally, indicated for malignant tumors. We resect the affected jaw bone with the intact part included, and remove the affected parts from the resected jaw portion under direct observation, then decorticate the inner layer of the cortical bone and drill small holes on the cortical bone to prevent the cracking by deep freezing and to ensure the revascularization from the surrounding soft tissue. In order to kill the tumor cells within the resected jaw bones totally, we use two different freezing and warming treatments. The resected jaw portion is put into the freezing chamber at-85 degrees C for 45 minutes, and then immersed into physiological saline solution at+ 45 degrees C for 15 minutes. When the freezing apparatus is not available, the resected jaw portion is immersed into liquid nitrogen at-195 degrees C for 5 minutes, and then immersed into phisological saline solution at 45 degrees C for 10 minutes. These treatments are repeated three times respectively. After the treatment the cells in the lesion decreased in number and became low staining drastically. In the malignant cases the resected jaw portion is treated by the freezing and warming mentioned above, then lyophilized and stored in a vacuous bottle at the room temperature for over 18 months. The combination of resected jaw portion and fresh autogenous marrow and cancellousbone are used for reconstruction. The former is expected to play a role as an anatomical template, and the latter is used as a material capable of inducting osteogenesis. The one-stage procedure was performed in 6 cases and two-stage procedure in 2 cases. The mandibular reconstruction was performed in 7 eases and maxillary reconstruction in 1 case. No tumor recurrence was observed and satisfactory results without complication were obtained. At the postoperative biopsy of time reimplanted area, a large number of bone cells were observed in the bone that presented layers and remodelling, implying the absorption and new bone formation in the reimplanted bone.
社団法人日本口腔外科学会の論文

Reconstruction procedures of jaw bones by using reimplantation of resected jaw portion treated by freezing and warming.

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