Mandibular Continuity Defects Research Articles

Lyophilized platelet rich fibrin and gelatin incorporated bioadhesive bone cement composite for repair of mandibular continuity defects

Mandibular continuity defects stem from conditions such as malignancies, trauma, cysts, osteomyelitis and osteoradionecrosis, presenting significant challenges. If mandibular reconstruction fails, it can result in facial collapse, causing significant aesthetic and functional concerns for the patient. In the present study we developed a bio-adhesive Bone Cement (BC) enriched with lyophilised PRF and gelatin to enhance bone repair and induce regeneration. The developed BC consisted of a mixture of Tetracalcium Phosphate (TTCP) and O-Phospho-l-serine (OPLS) in addition to lyophilised Platelet Rich Fibrin (PRF) for sustained growth factor release and gelatin (GE) for improved cement resorption. It is primarily designed for in-situ application, conforming to the shape and size of the defect for effective bone repair and regeneration. The study evaluated four groups: (i) BC (control), (ii) BC-GE (control), (iii) BC-PRF, and (iv) BC-GE-PRF. All the four groups were characterised using FTIR, SEM and XRD. The mechanical studies of the prepared beads exhibited a significant increase in the compressive strength of the PRF loaded bone cement composites. In vitro degradation study of the beads over a 60-day period revealed a significantly higher percentage of bone cement resorption in the gelatin-incorporated groups, BC-GE (44 ± 0.5 %), and BC-GE-PRF (45 ± 2 %). The assessment of growth factor release (TGF-β and VEGF) using ELISA revealed a prolonged and sustained release of both growth factors over a 28-day period. In vitro studies were performed on human Dental Follicle Stem Cells (DFSCs) to assess cell attachment, proliferation, mineralisation and osteogenic differentiation. These studies clearly depicted that BC-PRF and BC-GE-PRF showed significantly greater proliferation of DFSCs. Furthermore, BC-PRF and BC-GE-PRF samples exhibited notably elevated expression of Runx2 and OPN (osteogenic markers), as well as a higher intensity of alizarin red stain (mineralisation). Therefore, it was concluded that PRF incorporated bioadhesive bone cement composites greatly enhance the cell attachment, proliferation, mineralisation and osteogenic differentiation of the DFSCs. Thus, the PRF and gelatin incorporated bone cement composites is expected to facilitate effective and faster bone regeneration and healing in a wide range of dental and maxillofacial defects.

Review of the Literature on the Current State of Periosteum-Mediated Craniofacial Bone Regeneration

Study Design This is an article review on the current state of periosteum-mediated bone regeneration (PMBR). It is a known mandibular reconstruction option in children, and though poorly understood and unpredictable, the concerns of developmental changes to donor and recipient tissues shared by other treatment options are nonexistent. The definitive role of periosteum during bone regeneration remains largely unknown. Objective The objective is to review the literature on the clinical and molecular mechanism evidence of this event. Methods Our search methodology was modeled after the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Search strategies were categorized into search 1 for clinical evidence of mandibular regeneration and search 2 for gene expression review for craniofacial regeneration. The quality assessment of each publication was undertaken, and inclusion criteria comprise mandibular continuity defect for search 1 and use of gene expression assay propriety kit for search 2. Results 33 studies were selected for search 1 while four studies with non-human subjects were selected for search 2. Monitoring of PMBR onset was advised at 2 weeks post-operative, and the gene expression results showed an upregulation of genes responsible for angiogenesis, cytokine activities, and immune–inflammatory response in week 1 and skeletal development and signaling pathways in week 2. Conclusions The results suggest that young periosteum has a higher probability of PMBR than adult periosteum, and skeletal morphogenesis regulated by skeletal developmental genes and pathways may characterize the gene expression patterns of PMBR.

Patient Specific Alloplastic Implant Reconstruction of Mandibular Defects-Safe Practice Recommendations and Guidelines.

Mandibular continuity defects are commonly seen after tumor resection, osteomyelitis or maxillofacial trauma. Three-dimensional reconstruction of these mandibular segmental defects is critical for proper mandibular functioning and esthetics. Various methods used to reconstruct such defects include bridging reconstruction plates, modular endoprosthesis, non-vascularized and vascularized bone grafting with stock reconstruction plate or patient specific implants (PSI) and tissue engineering bone transfer. But in the recent years, literature documents use of PSI only alloplastic reconstruction as an alternate to microvascular bone flap reconstruction. Representative cases enumerate current practice of 'patient specific implant only' mandibular reconstruction and its pitfalls. This article discusses current status of literature on PSI's, choice of indications for 'PSI only' mandibular reconstruction and also proposes guidelines for safe practice of patient specific implant reconstruction of mandible.

Patient-Specific Bioimplants and Reconstruction Plates for Mandibular Defects: Production Workflow and In Vivo Large Animal Model Study.

A major challenge with extensive craniomaxillofacial bone reconstruction is the limited donor-site availability to reconstruct defects predictably and accurately according to the anatomical shape of the patient. Here, patient-specific composite bioimplants, consisting of cross-linked poly(trimethylene carbonate) (PTMC) networks and β-tricalcium phosphate (β-TCP), are tested in vivo in twelve Göttingen minipigs in a large mandibular continuity defect model. The 25mm defects are supported by patient-specific titanium reconstruction plates and receive either osteoconductive composite bioimplants (PTMC+TCP), neat polymer network bioimplants (PTMC), autologous bone segments (positive control), or are left empty (negative control). Postoperatively, defects treated with bioimplants show evident ossification at 24 weeks. Histopathologic evaluation reveals that neat PTMC bioimplant surfaces are largely covered with fibrous tissue, while in the PTMC+TCP bioimplants, bone attached directly to the implant surface shows good osteoconduction and histological signs of osteoinductivity. However, PTMC+TCP bioimplants are associated with high incidence of necrosis and infection, possibly due to rapid resorption and/or particle size of the used β-TCP. The study highlights the importance of testing bone regeneration implants in a clinically relevant large animal model and at the in situ reconstruction site, since results on small animal models and studies in nonloadbearing areas do not translate directly.

Design Criteria for Patient-specific Mandibular Continuity Defect Reconstructed Implant with Lightweight Structure using Weighted Topology Optimization and Validated with Biomechanical Fatigue Testing.

This study developed design criterion for patient-specific reconstructed implants with appearance consideration and structural optimization of various mandibular continuity defects. The different mandible continuity defects include C (from left to right canines), B (from 1st premolar to 3rd molar), and A (from 3rd molar to ramus) segments defined based on the mandible image. The finite element (FE) analysis and weighted topology optimization methods were combined to design internal support beam structures within different reconstructed implants with corresponding occlusal conditions. Five continuity mandibular defects (single B/C/A+B and combination of B+C and B+C+B segments) were restored using additive manufacturing (AM) reconstructed implant and bone plate to confirm reasonable design criterion through biomechanical fatigue testing. The worst mandible strength was filtered based on the material mechanics and results from segmental bone length, thickness, and height statistics from the established database containing mandible images of 105 patients. The weighted optimization analysis results indicated that the sizes and positions of internal supporting beams within the reconstructed C, B, and A+B implants can be defined parametrically through corresponding segmental bone length, width, and height. The FE analysis found that the weight variation percentage between the parametric designed implants and original core solid implants in the C, B, and A+B was reduced by 54.3%, 63.7%, and 69.7%, respectively. The maximum stress values of the reconstructed implant and the remaining bone were not obviously reduced but the stress values were far lower than the material ultimate strength. The biomechanical fatigue testing indicated that all cases using the AM reconstructed implant could pass the 250,000 dynamic load. However, condyle head, bone plate fracture, and bone screw loosening could be found in cases using bone plates. This study developed a design criterion for patient-specific reconstructed implants for various mandibular continuity defects applicable for AM to further clinical use.

Primary Reconstruction of Mandibular Defects after Resection of Aggressive Pediatric Mandibular Tumors by Split Rib Bundle Bone Graft. A Retrospective Study

Background: A retrospective study was done to evaluate the success rate of immediate reconstruction by split rib bundle bone grafting after segmental resection of Aggressive Pediatric mandibular tumors. Materials and Patients: The present study enrolled sixty-one pediatric patients with aggressive mandibular tumors that had been treated during the period from January 2008 to December 2018. All patients were examined clinically and radiographically by Orthopantomograms, CTs and CBCTs. Radical segmental resection with resultant mandibular continuity defects were thus created followed by immediate reconstruction with non-vascularized Split Rib Bundle Bone Graft (SRBBG). Patients were then rehabilitated by osseointegrated implants with fixed or removable partial dentures. Success of reconstruction was assessed by the percentage of complications, interincisal opening and patient satisfaction. Assessment was performed at 1,3,6 and 12 months postoperatively. All patients were followed up for 4-7 years. Results: Successful reconstruction was accomplished in 55 patients (90.16 %). Successful dental rehabilitation was accomplished in 49 patients (89%). Three patients had complete failure due to severe postoperative infection. Another three cases had partial resorption of the graft due to moderate infection to whom re-augmentation by another rib graft had been performed. Conclusion: Pediatric aggressive mandibular tumors should be treated in an aggressive manner relative to its biologic behavior and immediate reconstruction is advocated. The Split Rib Bundle Bone Graft is an adequate alternative for mandibular reconstruction in the absence of microvascular surgery as it shows early revascularization thus permitting rehabilitation with successfully osseointegrated dental implants.

Pre-contoured reconstruction plate fabricated via three-dimensional printed bending support.

A mandibular continuity defect can be repaired using either a prosthetic device or autogenous bone. A titanium reconstruction plate can be used with a localized or vascularized flap over the defect of the mandible. Unfortunately, the plate may fail due to plate exposure, screw loosening, fracture, or infection, and will need to be removed. Plate exposure though the skin or mucosa is one of the main reasons for failure. In the present work, the authors introduced a lingually positioned reconstruction plate fabricated via three-dimensional printed bending support. This custom reconstruction plate can avoid plate re-exposure as well as reduce surgical errors and operation time.

Outcome Assessment for Surgical Reconstruction of Mandibular Continuity Defects.

Mandibular continuity defects are associated with multiple functional and esthetic problems. Nonvascularized bone grafting is one of several surgical corrective techniques for such defects with good success predictability. This retrospective clinical study reviewed the outcome of this technique when applied in its 2 protocol variations while minimizing the effect of as many confounding factors as possible through the application of strict eligibility criteria. The surgical records of 16 patients constituted the final sample: 10 patients in the one-stage and 6 patients in the two-stage reconstruction groups. It was found that mandibular reconstruction with nonvascularized bone graft is a good first option as well as a viable alternative in the absence of free flap procedure facilities. Patients' initial expectations should be a crucial factor in deciding the appropriate surgical treatment protocol form the early planning stage. Standardizing success parameters in such cases could further improve objectivity and allow for multi-center research data pooling with reduced effect of heterogeneity featuring these complex injuries.

3D-printed PEEK implant for mandibular defects repair - a new method

Functional reconstruction of large-size mandibular continuity defect is still a major challenge in the oral and maxillofacial surgery due to the unsatisfactory repair effects and various complications. This study aimed to develop a new functional repair method for mandibular defects combined with 3D-printed polyetheretherketone (PEEK) implant and the free vascularized fibula graft, and evaluated the service performance of the implant under whole masticatory motion. The design criteria and workflows of the mandibular reconstruction were established based on the requirements of safety, functionality, and shape consistency. Both the biomechanical behavior and the mechanobiological property of mandibular reconstruction under various masticatory motion were investigated by the finite element analysis. The maximum von Mises stress of each component was lower than the yield strength of the corresponding material and the safety factor was more than 2.3 times, which indicated the security of the repair method can be guaranteed. Moreover, the actual deformation of the reconstruction model was lower than that of the normal mandible under most clenching tasks, which assured the primary stability. More than 80% of the volume elements in the bone graft can obtain effective mechanical stimulation, which benefited to reduce the risks of bone resorption. Finally, the novel repair method was applied in clinic and good clinical performances have been achieved. Compared with the conventional fibular bone graft for surgical mandibular reconstruction, this study provides excellent safety and stability to accomplish the functional reconstruction and aesthetic restoration of the mandible defect.

Myxofibrosarcoma of the mandible: a case report and review of the literature

BackgroundMyxofibrosarcoma (MFS) is a soft tissue sarcoma that commonly occurs in late adult life. It is mainly located in the subcutaneous soft tissues of extremities characterized by a high recurrence rate at the original site. MFS of the head and neck is rare, while it occurs in the maxilla and mandible is extremely rare.Case presentationWe report a case of MFS of the mandible in a 51-year-old female who presented with a painless gingival swelling and mobile, super-erupted right mandibular second and third molars. Panoramic x-ray and maxillofacial CT revealed an ill-defined radiolucent lesion surrounding the mandibular molars giving a teeth-floating-in-air appearance. Histopathological examination showed scattered spindle and stellate cells with mild atypia distributed in the myxoid stroma. Only a few mitotic figures were identified and no area of tissue necrosis was found. The characteristic thin-walled and curvilinear vasculature were prominent. Immunohistochemistry analysis revealed the tumor cells being positive for vimentin and vascular CD31. CK, S-100, P63, HHF-35 stains were negative. The labeling index of Ki-67 was about 30%. Based on the histopathological and immunohistochemical examinations, the diagnosis of a low-grade MFS was established. This patient underwent a radical segmental excision with a 2-cm margin, supraomohyoid neck dissection and immediate reconstruction of the mandibular continuity defect with a fibular osteocutaneous free flap. This patient has been followed for 20 months to date and has remained disease free.ConclusionsThis report describes a rare case of MFS of the mandible. Recognizing the histopathological features of MFS and applying the appropriate immunohistochemical examinations are crucial in establishing the correct diagnosis. Our case may provide diagnosis and treatment experiences of MFS occurs in the mandible.

Novel finite element-based plate design for bridging mandibular defects: Reducing mechanical failure.

IntroductionWhen the application of a free vascularised flap is not possible, a segmental mandibular defect is often reconstructed using a conventional reconstruction plate. Mechanical failure of such reconstructions is mostly caused by plate fracture and screw pull‐out. This study aims to develop a reliable, mechanically superior, yet slender patient‐specific reconstruction plate that reduces failure due to these causes.Patients and MethodsEight patients were included in the study. Indications were as follows: fractured reconstruction plate (2), loosened screws (1) and primary reconstruction of a mandibular continuity defect (5). Failed conventional reconstructions were studied using finite element analysis (FEA). A 3D virtual surgical plan (3D‐VSP) with a novel patient‐specific (PS) titanium plate was developed for each patient. Postoperative CBCT scanning was performed to validate reconstruction accuracy.ResultsAll PS plates were placed accurately according to the 3D‐VSP. Mean 3D screw entry point deviation was 1.54 mm (SD: 0.85, R: 0.10–3.19), and mean screw angular deviation was 5.76° (SD: 3.27, R: 1.26–16.62). FEA indicated decreased stress and screw pull‐out inducing forces. No mechanical failures appeared (mean follow‐up: 16 months, R: 7–29).ConclusionReconstructing mandibular continuity defects with bookshelf‐reconstruction plates with FEA underpinning the design seems to reduce the risk of screw pull‐out and plate fractures.

Is Reconstruction of Large Mandibular Defects Using Bioengineering Materials Effective?

Clinical tissue engineering has revolutionized surgery by improving surgical efficiency and decreasing the risks associated with traditional bone graft procurement techniques. Compared with autogenous bone grafts, composite tissue-engineered grafts fulfill the principles of osteoconduction, osteoinduction, and osteogenesis and provide adequate bone volume for maxillofacial reconstruction with less morbidity. The present study aimed to demonstrate the effectiveness, as defined by our success criteria, of a composite tissue-engineered bone graft in the reconstruction of mandibular defects. We implemented a retrospective case series and enrolled a sample of patients with mandibular defects that had been reconstructed using allogeneic bone combined with recombinant human bone morphogenic protein-2 and bone marrow aspirate concentrate at our institution during a 5-year period. The success criteria were as follows: 1) bone union, defined as a homogenous radiopaque pattern continuous with native bone without mandibular mobility; and 2) volume of grafted bone adequate for implant placement, defined as at least 1.0cm (height) by 0.8cm (width). Clinical examinations and computed tomography scans were performed at 6months postoperatively. Descriptive statistics were computed for each variable. From 2014 to 2019, tissue engineering reconstruction was used in 31 patients with and 3 patients without mandibular continuity defects, for a total of 34 patients. The median follow-up was 6months. The mean length of the continuity defects was 5.5cm (range, 1.0 to 12.5). Of the 30 patients with mandibular continuity defects, 27 achieved success according to our criteria, with an average gained height of 2.12±0.64cm and width of 1.53±0.46cm. Of the 34 patients, 1 was lost to follow-up, and treatment failed in 3 patients. Although the use of autogenous graft remains the reference standard, the evolving science behind clinical tissue engineering has resulted in an effective treatment modality for complex head and neck defects with less morbidity and graft material equal to that of autogenous bone.

Reconstruction plate-related complications in mandibular continuity defects.

The purpose of this study was to evaluate the complications associated with the use of reconstruction plates with or without non-vascularized bone graft in reconstruction of mandibular segmental defects caused by trauma and tumor resection and to analyze various factors that are associated with the development of complications. A retrospective observational study was conducted, and the investigated variables included the age and gender of the patients, etiology of the defect, the site of the defect, the size of the defect, whether bone graft was used or not, type of plate used, and whether the reconstruction was immediate or delayed. The outcome variables were the postoperative complications and the success rate. Fifty-one patients were enrolled in this study; the etiology of mandibular defect was trauma in 39 patients (76.5%) and resection of benign or malignant tumors in 12 patients (23.5%). The complication rate was (58.8%) and the success rate was (94.1%); the only factor that significantly increased the incidence of postoperative complications was the size of the defect. Reconstruction plates demonstrated a high success rate despite the high complication rate. Segmental defects caused by trauma were smaller than those created after tumor resection and the only factor that increased complication rate was the size of the defect; other factors did not affect the complication rate.

Localized low-dose rhBMP-2 is effective at promoting bone regeneration in mandibular segmental defects.

At least 26% of recent battlefield injuries are to the craniomaxillofacial (CMF) region. Recombinant human bone morphogenetic protein 2 (rhBMP-2) is used to treat CMF open fractures, but several complications have been associated with its use. This study tested the efficacy and safety of a lower (30% recommended) dose of rhBMP-2 to treat mandibular fractures. rhBMP-2 delivered via a polyurethane (PUR) and hydroxyapatite/β-tricalcium phosphate (Mastergraft®) scaffold was evaluated in a 2 cm segmental mandibular defect in minipigs. Bone regeneration was analyzed at 4, 8, and 12 weeks postsurgery using clinical computed tomography (CT) and rhBMP-2, and inflammatory marker concentrations were analyzed in serum and surgery-site drain effluent. CT scans revealed that pigs treated with PUR-Mastergraft® + rhBMP-2 had complete bone bridging, while the negative control group showed incomplete bone-bridging (n = 6). Volumetric analysis of regenerated bone showed that the PUR-Mastergraft® + rhBMP-2 treatment generated significantly more bone than control by 4 weeks, a trend that continued through 12 weeks. Variations in inflammatory analytes were detected in drain effluent samples and saliva but not in serum, suggesting a localized healing response. Importantly, the rhBMP-2 group did not exhibit an excessive increase in inflammatory analytes compared to control. Treatment with low-dose rhBMP-2 increases bone regeneration capacity in pigs with mandibular continuity defects and restores bone quality. Negative complications from rhBMP-2, such as excessive inflammatory analyte levels, were not observed. Together, these results suggest that treatment with low-dose rhBMP-2 is efficacious and may improve safety when treating CMF open fractures. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1491-1503, 2019.

The Efficacy of Bioengineering (Stem Cells, Allogeneic Bone, and rhBMP-2) for Reconstruction of Large Mandibular Continuity Defects: A Retrospective Study of 24 Patients over a 3-Year Period

The Efficacy of Bioengineering (Stem Cells, Allogeneic Bone, and rhBMP-2) for Reconstruction of Large Mandibular Continuity Defects: A Retrospective Study of 24 Patients over a 3-Year Period

Reconstruction of Lateral Mandibular Defects with Soft Tissue Loss: The Role of the Submental Flap.

Mandibular continuity defects after pathologic resections or traumatic events are difficult cases for reconstruction. Defects involving both hard and soft tissue loss are more challenging, because of problems in soft tissue coverage. The role of the submental flap in this regard is presented. In a retrospective study from the archived files of Ghaem Hospital, Mashhad, Iran between 2007-2016, lateral mandibular defects that were managed with submental flap for soft tissue coverage were selected. Ten patients had been treated, of whom four cases were due to trauma/gunshot events and six cases were defined as pathologic resection; five patients with malignant lesions and one with benign intraosseous pathology, but with soft tissue invasion. There was one complication overall, concerning orocutaneous fistula formation. Submental flap is indicated for coverage of the reconstruction plate when the lateral mandible is resected/avulsed with soft tissue loss limited to the oral cavity or due to through and through defects in the lower third of the face.

Virtual Surgical Planning Using Stereolithographic Models for Segmental Mandibular Resection with Limited Extraoral Skin Incision versus Traditional Surgical Protocols

Purpose: To evaluate, both clinically and radiographically the usage of stereolithographic model with limited extraoral skin incision versus the traditional method using dry mandibles in preoperative adaptation of locking reconstruction plate for lateral mandibular continuity defects in delayed type mandibular reconstruction. Materials and methods: Sixteen patients were randomly classified into two equal groups; in which group I was the control (traditional method) and group II was the study group (new method). Group (I): 8 patients with mandibular lesions indicated for segmental mandibular resections via intraoral approach and a wide extraoral incision assisted with preoperative adaptation of the reconstruction plate on dry mandible and refined intraoperatively with the use of a plastic template. Group (II): 8 patients with mandibular lesions indicated for segmental mandibular resections via intraoral approach and with very limited extraoral incision assisted with preoperative adaptation of the reconstruction plate on the patient`s stereolithographic model. Results: The operation time, plate bending and adaptation time, the intraoperative blood loss, scar visibility, TMJ dysfunction, facial asymmetry, accurate plate adaptation, proper plate angulation, and plate over-extension especially in the proximal segment beyond the sigmoid notch, all were with statistically significant differences between both groups with better results always found in group II patients. However, no cases of tumor recurrence, plate exposure, or abnormal condylar position were recorded at the last follow up visit (6 months) in both groups. Conclusion: The use of the patient`s 3-D steriolithographic model for virtual surgical planning for segmental mandibular resection with limited skin incision has several advantages over the traditionally used method. It improves reconstruction of form and function, decreases operating room time and complications and enhances the capability to perform more accurate surgical procedures.

Antibody-Mediated Osseous Regeneration for Bone Tissue Engineering in Canine Segmental Defects

Among many applications of therapeutic monoclonal antibodies (mAbs), a unique approach for regenerative medicine has entailed antibody-mediated osseous regeneration (AMOR). In an effort to identify a clinically relevant model of craniofacial defect, the present study investigated the efficacy of mAb specific for bone morphogenetic protein- (BMP-) 2 to repair canine segmental mandibular continuity defect model. Accordingly, a 15 mm unilateral segmental defect was created in mandible and fixated with a titanium plate. Anorganic bovine bone mineral with 10% collagen (ABBM-C) was functionalized with 25 μg/mL of either chimeric anti-BMP-2 mAb or isotype-matched mAb (negative control). Recombinant human (rh) BMP-2 served as positive control. Morphometric analyses were performed on computed tomography (CT) and histologic images. Bone densities within healed defect sites at 12 weeks after surgery were 1360.81 ± 10.52 Hounsfield Unit (HU), 1044.27 ± 141.16 HU, and 839.45 ± 179.41 HU, in sites with implanted anti-BMP-2 mAb, rhBMP-2, and isotype mAb groups, respectively. Osteoid bone formation in anti-BMP-2 mAb (42.99% ± 8.67) and rhBMP-2 (48.97% ± 2.96) groups was not significantly different but was higher (p < 0.05) than in sites with isotype control mAb (26.8% ± 5.35). In view of the long-term objective of translational application of AMOR in humans, the results of the present study demonstrated the feasibility of AMOR in a large clinically relevant animal model.

Custom Implant for Reconstruction of Mandibular Continuity Defect

The purpose of this study was to compare the daily food intake rate and the rate of screw loosening between 2 groups of rabbits with mandibular continuity defects: custom implant (CI) group and 5-hole mini-plate group. Two types of cylindrical implants were printed, and their physical strength was compared. In this study using rabbits, 1 group (n=5) received a CI for the reconstruction of a mandibular continuity defect (CI group) and the other group (n=5) received a 5-hole mini-plate without a bone graft (reconstruction plate [RP] group). After reconstruction, the daily food intake rate and the rate of screw loosening were examined postoperatively. Histologic examination in the CI group was performed 3months after the operation. The design that mimicked the mandible showed greater physical strength. The amount of time required to achieve 50% recovery was shorter in the CI group than in the RP group (P=.011).The total number of loosened screws in the CI group was lower than that in the RP group at 3months postoperatively (P=.008). New bone formation in the porous CI was evident in the CI group. Rabbits with mandibular continuity defects treated with CIs for reconstruction showed faster recovery of the daily food intake rate and fewer loosened screws than those treated with a 5-hole mini-plate without bone graft.

Erratum to "Collagen Sponge Functionalized with Chimeric Anti-BMP-2 Monoclonal Antibody Mediates Repair of Critical-Size Mandibular Continuity Defects in a Nonhuman Primate Model".

[This corrects the article DOI: 10.1155/2017/8094152.].