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Mandible Reconstruction Project

Summary

The Mandible Reconstruction Project is a unique, ongoing, multi-disciplinary effort involving the University of Illinois College of Engineering, the Beckman Institute for Advanced Science and Technology, Sandia National Laboratories, and Carle Foundation Hospital to develop an alternative approach to bone replacement--one that obviates the bone harvest surgery without diminishing the superior clinical outcomes associated with autografting. In completing the first phase of the project, the team of collaborators have developed an integrated workflow from surgeon to modeler that yields a perfectly-fitting custom device that demonstrates the feasibility of this approach in a real clinical setting.


Background

The replacement of bone lost through disease or injury presents a continuing clinical challenge. The current "gold standard" is autograft bone, i.e. bone taken from another site in the body. The surgical procedures for the harvesting of such bone can result in complications that are "minor" (hematoma, temporary sensory loss, acute pain); or "major" (permanent sensory loss, chronic pain, infection). Complication rates exceeding 30% have been reported for autograft harvesting from the iliac crest of the pelvis, a common source for autograft bone. The alternative to autografting is implantation of cadaver bone. From a clinical perspective this is an even less attractive option which increases the complication rates associated with autografting and adds the risk of disease transmission to the procedure.


The Next Steps

A good deal of research remains to be done before these devices will be available for clinical use. While our initial findings have been encouraging, the rigorous process of establishing the safety and efficacy of this device will require a number of years of laboratory and clinical research and substantial investment. It is our objective to develop a design approach that provides to the surgeon customized synthetic bone scaffolds that rival the healing and remodeling results now achieved with autografting. And one that provides to the patient safe and rapid healing without the risk and discomfort of the additional surgery that autografting requires.



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