Histological and Microvascular Changes during Healing of a Mandibular Defect Packed with a Secondary Living Free Bone Graft

Abstract

     A living free bone graft is the most effective treatment for reconstruction of bone defects. However, it is limited by anatomical factors, such as the length of the pedicle and the blood supply to the donor bone. I attempted to demonstrate the possibility of creating a new donor site for secondary living bone grafts free from anatomical constraints, and to apply this technique to mandibular reconstruction.
     I investigated histological and microvascular changes in a vascular bundle transplanted into the tibia of a rabbit (Group 1) and during the healing process of a mandibular defect in the same animal packed with a secondary living free bone graft from the tibia (Group 2).
     Three weeks after transplantation in Group l the transplanted vascular bundles communicated with the pre-existing medullary vessels via the newly-formed capillaries. In Group 2 establishment of circulation in the pre-existing vessels of the donor was observed five days after transplantation, and the donor material was completely fused with the mandible by four weeks.
     The secondary living free bone graft seems a clinically effective treatment for mandibular defects.