Bone Tissue Reconstruction Research Articles

Synergy of engineered gelatin methacrylate-based porous microspheres and multicellular assembly to promote osteogenesis and angiogenesis in bone tissue reconstruction

One of the key challenges in bone defects treatment is providing adequate and stable blood supply during new tissue regeneration. Mesenchymal stem cells (MSCs) and endothelial cells (ECs) have great potential to promote osteogenesis and angiogenesis during bone defect repair through paracrine effects, but their therapeutic efficacy depends on effective cellular assembly and delivery. In this work, we developed various microspheres with different pore sizes for multi-cellular delivery to enhance the angiogenic and osteogenic capability via combining microfluidic and gradient freeze-drying techniques. The particle and pore size of fabricated porous gelatin methacrylate (GelMA)-based hydrogel microspheres (PGMS) could be controllable through adjusting the freezing time of hydrogel microspheres, the range of particles and pores size are 150–250 μm and 10–100 μm with different freezing time from 0 min to 30 min. The optimized particle size (200.8 ± 14.2 μm) and pore size (11.2 ± 1.9 μm) were explored to promote cell assemble, adhesion, growth, and proliferation in the PGMS. Furthermore, the co-assembly and delivery of bone marrow mesenchymal stem cells (BMSCs) and human umbilical vein endothelial cells (HUVECs) on the PGMS was achieved and an optimal cellular ratio of BMSCs to HUVECs (20:2) was established for co-culturing of them to achieve optimal paracrine effects, further promoting osteogenic differentiation and angiogenesis. Finally, results from both in vitro and in vivo experiments showed that the developed PGMS with co-assembly of BMSCs to HUVECs contributed to accelerate bone regeneration and vascularization process daringly, exhibited great potential in vascularized bone tissue reconstruction.

Investigation of treatment outcomes for severe extremity trauma in an independent orthopedic trauma center: A case series

BackgroundSevere extremity trauma is one of the most challenging injuries to treat. Limb salvage after severe extremity trauma requires rapid revascularization, accurate and appropriate bone and soft tissue reconstruction, and appropriate management to address critical complications. The purpose of this study was to report the treatment outcomes for severe extremity trauma injuries at our independent orthopedic trauma center. MethodsThis study included patients with severe extremity trauma who underwent major vascular repair or soft tissue reconstruction. Bone reconstruction method, presence or absence of revascularization, and flap type were investigated. Complications were investigated, including revascularization failure, flap failure, infection, and ultimately, whether amputation was required. Additionally, we investigated the number of surgeries performed on each patient at the time of initial hospitalization. ResultsThirty-five patients who underwent revascularization or soft tissue reconstruction were included in this study. Plate fixation was performed in 18 patients, intramedullary nail fixation in 8, screw fixation in 1, pinning in 4, and without implant fixation in 4. Revascularization was performed in six patients, and no vascular complications occurred. Pedicled and free flaps were used in 17 and 16 patients, respectively. Partial flap necrosis occurred in four patients, and arterial occlusion occurred in one. Infection occurred in 10 patients who were treated with frequent irrigation and high-concentration antibiotics local infusion therapy. None of the 35 patients required limb amputation. Mean number of surgeries was 12.5. ConclusionsThe limb of all the 35 patients with severe extremity trauma treated at our independent orthopedic trauma center were salvaged.

Preparation, structure, osteogenic differentiation ability, and biosafety of bioglass for root canal disinfection

In this paper, SiO2-P2O5-Ca(Sr/Zn)O-Na2O-F system glasses with varying CaO:SrO and CaO:ZnO ratios were prepared by traditional melting method, which combined the remineralization properties of bioglass with the special functions of Zn2+ and Sr2+. The evolution of glass composition and its thermal properties, network structure, and biological properties was investigated by DSC, FTIR, and biological experiment. The results showed that all the extracts of glass powder could promote the osteogenic differentiation of human periodontal ligament cells (HPDLCs). Among them, the two kinds of glass containing 6 wt% SrO and only 2 wt% ZnO had the greatest potential to accelerate the bone tissue reconstruction. Hematoxylin-eosin (HE) staining histological results showed that 3 months after the two kinds of glass were implanted in the animal model of periapical inflammation, the bone matrix formed a good seal in the apical foramen, and new bone and capillaries were formed in the apical area, which has a clinical application and transformation prospect.

Application of autogenous block bone graft in the reconstruction of severe alveolar crest defect

Patients with severe alveolar ridge defects cannot be directly implanted and repaired, which seriously affects their quality of life. Onlay bone grafting is the main solution for severe alveolar ridge bone defect reconstruction, among which autogenous block bone grafting is the most widely used and is also the focus of clinical research on bone tissue reconstruction. This article expounds the characteristics and basic principles of autogenous bone block grafting, and comprehensively analyzes the selection of autogenous bone donor site, the principles of surgical operation, and the progress of bone graft techniques. In order to help surgeons make correct clinical decisions, increase the predictability of surgical effects, and improve the level of clinical diagnosis and treatment.

An Elastin-Derived Composite Matrix for Enhanced Vascularized and Innervated Bone Tissue Reconstruction: From Material Development to Preclinical Evaluation.

Despite progress in bone tissue engineering, reconstruction of large bone defects remains an important clinical challenge. Here, a biomaterial designed to recruit bone cells, endothelial cells, and neuronal fibers within the same matrix is developed, enabling bone tissue regeneration. The bioactive matrix is based on modified elastin-like polypeptides (ELPs) grafted with laminin-derived adhesion peptides IKVAV and YIGSR, and the SNA15 peptide for retention of hydroxyapatite (HA) particles. The composite matrix shows suitable porosity, interconnectivity, biocompatibility for endothelial cells, and the ability to support neurites outgrowth by sensory neurons. Subcutaneous implantation leads to the formation of osteoid tissue, characterized by the presence of bone cells, vascular networks, and neuronal structures, while minimizing inflammation. Using a rat femoral condyle defect model, longitudinal micro-CT analysis is performed, which demonstrates a significant increase in the volume of mineralized tissue when using the ELP-based matrix compared to empty defects and a commercially available control (Collapat). Furthermore, visible blood vessel networks and nerve fibers are observed within the lesions after a period of two weeks. By incorporating multiple key components that support cell growth, mineralization, and tissue integration, this ELP-based composite matrix provides a holistic and versatile solution to enhance bone tissue regeneration.

Critical Bone Defect Affecting the Outcome of Management in Anatomical Type IV Chronic Osteomyelitis.

The Cierny and Mader classification assists with decision-making by stratifying host status and the pathoanatomy of the disease. However, the anatomical type IV represents a heterogenous group with regard to treatment requirements and outcomes. We propose that modification of the Cierny and Mader anatomical classification with an additional type V classifier (diffuse corticomedullary involvement with an associated critical bone defect) will allow more accurate stratification of patients and tailoring of treatment strategies. A retrospective review of 83 patients undergoing treatment for Cierny and Mader anatomical type IV osteomyelitis of the appendicular skeleton at a single centre was performed. Risk factors for the presence of a critical bone defect were female patients [OR 3.1 (95% CI, 1.08-8.92)] and requirement for soft tissue reconstruction [OR 3.35 (95% CI, 1.35-8.31)]; osteomyelitis of the femur was negatively associated with the presence of a critical bone defect [OR 0.13 (95% CI, 0.03-0.66)]. There was no statistically significant risk of adverse outcomes (failure to eradicate infection or achieve bone union) associated with the presence of a critical-sized bone defect. The median time to the bone union was ten months (95% CI, 7.9-12.1 months). There was a statistically significant difference in the median time to bone union between cases with a critical bone defect [12.0 months (95% CI, 10.2-13.7 months)] and those without [6.0 months (95% CI, 4.8-7.1 months)]. This study provided evidence to support the introduction of a new subgroup of the Cierny and Mader anatomical classification (Type V). Using a standardised approach to management, comparable early outcomes can be achieved in patients with Cierny and Mader anatomical type V osteomyelitis. However, to achieve a successful outcome, there is a requirement for additional bone and soft tissue reconstruction procedures with an associated increase in treatment time. Tsang STJ, Epstein GZ, Ferreira N. Critical Bone Defect Affecting the Outcome of Management in Anatomical Type IV Chronic Osteomyelitis. Strategies Trauma Limb Reconstr 2024;19(1):26-31.

Mimicking microbone tissue by 3-dimensional printing

Bones are mineralized connective tissues composed of osteoclasts, osteoblasts, and osteocytes. While bone is one of the few tissues that can regenerate in adulthood, its regeneration is limited in the case of large bone defects due to an environment that is detrimental to bone formation, which can be caused by soft tissue injury and impeded vascularization, ultimately reducing the potential for significant bone creation. Consequently, recent research has focused on tissue engineering and regenerative medicine to address these complex issues. This article reviews recent major advances in the cell components used for bone regeneration studies, specific markers of bone differentiation, 3-dimensional (3D) printing techniques for the structural mimicry of bones, and the use of natural and synthetic biomaterials. Functional bone structures and bone organoids can be created using 3D printing, which allows the reconstruction of bone tissue by attaching living cells to scaffolds. These scaffolds are designed with appropriate shapes and mechanical properties to mimic the bone microenvironment. The application of 3D printing in the development of bone organoids holds promise for providing improved solutions for the development of test systems for disease modeling and drug development.

CRITICAL BONE DEFECT AFFECTING THE OUTCOME OF MANAGEMENT IN ANATOMICAL TYPE IV CHRONIC OSTEOMYELITIS

IntroductionThe Cierny and Mader classification assists with decision-making by stratifying host status and the pathoanatomy of the disease. However, the anatomical type IV represents a heterogenous group with regards to treatment requirements and outcomes. We propose that modification of the Cierny and Mader anatomical classification with an additional type V classifier (diffuse corticomedullary involvement with an associated critical bone defect) will allow more accurate stratification of patients and tailoring of treatment strategies.Materials & MethodsA retrospective review of 83 patients undergoing treatment for Cierny and Mader anatomical type IV osteomyelitis of the appendicular skeleton at a single centre was performed.ResultsRisk factors for the presence of a critical bone defect were female patients (OR 3.1 (95% CI 1.08–8.92)) and requirement for soft tissue reconstruction (OR 3.35 (95% CI 1.35–8.31)); osteomyelitis of the femur was negatively associated with the presence of a critical bone defect (OR 0.13 (95% CI 0.03–0.66)). There was no statistically significant risk of adverse outcomes (failure to eradicate infection or achieve bone union) associated with the presence of a critical-sized bone defect. The median time to bone union was ten months (95% CI 7.9–12.1 months). There was a statistically significant difference in the median time to bone union between cases with a critical bone defect (12.0 months (95% 10.2–13.7 months)) and those without (6.0 months (95% CI 4.8–7.1 months))ConclusionsThis study provided evidence to support the introduction of a new subgroup of the Cierny and Mader anatomical classification (Type V). Using a standardised approach to management, comparable early outcomes can be achieved in patients with Cierny and Mader anatomical type V osteomyelitis. However, to achieve a successful outcome, there is a requirement for additional bone and soft tissue reconstruction procedures with an associated increase in treatment time.

Recent Progress in antibacterial hydrogel coatings for targeting biofilm to prevent orthopedic implant-associated infections.

The application of orthopedic implants for bone tissue reconstruction and functional restoration is crucial for patients with severe bone fractures and defects. However, the abiotic nature of orthopedic implants allows bacterial adhesion and colonization, leading to the formation of bacterial biofilms on the implant surface. This can result in implant failure and severe complications such as osteomyelitis and septic arthritis. The emergence of antibiotic-resistant bacteria and the limited efficacy of drugs against biofilms have increased the risk of orthopedic implant-associated infections (OIAI), necessitating the development of alternative therapeutics. In this regard, antibacterial hydrogels based on bacteria repelling, contact killing, drug delivery, or external assistance strategies have been extensively investigated for coating orthopedic implants through surface modification, offering a promising approach to target biofilm formation and prevent OIAI. This review provides an overview of recent advancements in the application of antibacterial hydrogel coatings for preventing OIAI by targeting biofilm formation. The topics covered include: (1) the mechanisms underlying OIAI occurrence and the role of biofilms in exacerbating OIAI development; (2) current strategies to impart anti-biofilm properties to hydrogel coatings and the mechanisms involved in treating OIAI. This article aims to summarize the progress in antibacterial hydrogel coatings for OIAI prevention, providing valuable insights and facilitating the development of prognostic markers for the design of effective antibacterial orthopedic implants.

РОЛЬ КОЛЛАГЕНА И ГИДРОКСИАПАТИТА В СОСТАВЕ КОМПОЗИЦИОННЫХ КОСТНОПЛАСТИЧЕСКИХ МАТЕРИАЛОВ, ИСПОЛЬЗУЕМЫХ В ЧЕЛЮСТНО-ЛИЦЕВОЙ ХИРУРГИИ (обзор литературы)

Abstract. Introduction. Bone tissue reconstruction is one of the most challenging problems of maxillofacial surgery. This paper provides a review of studies related to the use of hydroxyapatite- and collagen-based osteoplastic materials for jawbone defects. Aim of our study is the review of the latest information on how essential collagen and hydroxyapatite as part of osteoplastic composites used in maxillofacial surgery. Materials and Methods. The published topical studies are reviewed, dealing with the study of collagen and hydroxyapatite as part of osteoplastic composites. Results and Discussion. Collagen implants promote fibroblast proliferation, vascularization of nearby tissues and induce the formation of new bone tissue with its subsequent restructuring. Collagen was also used as a rapidly biodegrading material in form of a gel for the restoration of bone defects. Conclusions. Currently, considering the positive qualities of collagen and hydroxyapatite, we see their widespread use as part of composite bone plastic materials as promising.

Glass and Glass-Ceramic Porous Materials for Biomedical Applications

Abstract Biosilicate glasses and glass-ceramic materials obtained on their basis are an important research area in tissue engineering due to their ability to regenerate bones. The most important features of bioactive glasses include: the ability to biodegrade and high bioactivity. Appropriate porosity, pore size, surface structure and topography, chemical composition and ion release kinetics, as well as mechanical properties enable the adhesion of mesenchymal cells and their differentiation towards osteoblast cells and stimulate further proliferation and angiogenesis. This study concerns the subject of bioglass, in particular Bioglass 45S5 and glass-crystalline porous materials in the context of their properties enabling the reconstruction of bone tissue and possible applications. The article addresses crucial issues of shaping the properties of glass and glasscrystalline porous structures by introducing changes in their composition and the method of their production, and also discusses the importance of foaming agents.

CRITICAL BONE DEFECT AFFECTING THE OUTCOME OF MANAGEMENT IN ANATOMICAL TYPE IV CHRONIC OSTEOMYELITIS

The Cierny and Mader classification assists with decision-making in the management of osteomyelitis by strafying the host status and the pathoanatomy of disease. However the anatomical type IV represents a heterogenous group with regards to treatment requirements and outcomes. We propose that modification of the Cierny and Mader anatomical classification with an additional type V classifier (diffuse corticomedullary involvement with an associated critical bone defect) will allow more accurate stratification of patients and tailoring of treatment strategies.A retrospective review of 83 patients undergoing treatment for Cierny and Mader anatomical type IV osteomyelitis of the appendicular skeleton at a single centre was performed.Risk factors for the presence of a critical bone defect were female patients (OR 3.1 (95% CI 1.08– 8.92)) and requirement for soft tissue reconstruction (OR 3.35 (95% CI 1.35–8.31)); osteomyelitis of the femur was negatively associated with the presence of a critical bone defect (OR 0.13 (95% CI 0.03–0.66)). There was no statistical significant risk of adverse outcomes (failure to eradicate infection or achieve bone union) associated with the presence of a critical-sized bone defect. The median time to bone union was ten months (95% CI 7.9–12.1 months). There was a statistically significant difference in the median time to bone union between cases with a critical bone defect (12.0 months (95% 10.2–13.7 months)) and those without (6.0 months (95% CI 4.8–7.1 months))This study provided evidence to support the introduction of a new subgroup of the Cierny and Mader anatomical classification (Type V). Using a standardised approach to management, comparable early outcomes can be achieved in patients with Cierny and Mader anatomical type V osteomyelitis.However, to achieve a successful outcome, there is a requirement for additional bone and soft tissue reconstruction procedures with an associated increase in treatment time.

Effect of autologous lyophilized platelet‑rich fibrin on the reconstruction of osteochondral defects in rabbits.

Osteochondral defects caused by degenerative diseases of joints, traumas and inflammation are important issues in clinical practice. Different types of autologous platelet concentrate (PCs) are used in bone and cartilage regeneration. The present study aimed to investigate the effect of lyophilized platelet-rich fibrin (L-PRF) on the repair of osteochondral defects in rabbits. L-PRF was first prepared from fresh PRF (F-PRF) through freeze-drying, and histological and microstructural observations were performed to compare the characteristics of L-PRF and F-PRF. Thereafter, these bioactive scaffolds were implanted into osteochondral defects surgically created in rabbits to assess their effects on tissue repair using micro-CT scanning, histological observations and the evaluation scoring method for cartilage repair established by the International Cartilage Repair Society (ICRS). L-PRF had a histological structure similar to F-PRF. At 16 weeks after implantation surgery, full-thickness osteochondral defects with a diameter of 5 mm and a depth of 4 mm were well-filled with newly regenerated tissues, exhibiting the simultaneous regeneration of avascular articular cartilage and well-vascularized subchondral bone, as proven through macroscopic and microscopic observations in PRF-treated groups compared with that in the untreated group. The application of L-PRF and F-PRF for osteochondral defects in rabbits contributed to massive host remodeling and reconstruction of osteochondral tissues, thus offering a prospective bioactive scaffold for the simultaneous reconstruction of articular cartilage and subchondral bone tissue.

A Surgical Management Algorithm for Type 4 Parry-Romberg Syndrome.

Type 4 Parry-Romberg syndrome (PRS) affects multiple facial esthetic units involving many tissue types, requiring both bone and soft tissue restoration and requiring different surgical procedures over a long period of time. To date, the timing and sequence of these operations remains controversial. A retrospective analysis was performed to introduce our surgical management algorithm for type 4 PRS and to evaluate its safety and efficacy according to long-term follow-up results. Six Chinese patients (5 females and 1 male) fulfilled the inclusion criteria. The follow-up period ranged from 23 to 90 months (mean 51.83mo). All patients were satisfied with the improvement in facial appearance after staged bone and soft tissue reconstruction. No major complications were reported except for 1 case of infection after Medpor implantation. For severe PRS, both bone and soft tissue reconstruction is recommended. Enlargement of the bony framework provides a good foundation for subsequent soft tissue restoration. Alloplastic implants in the maxilla can be problematic if the patient has undergone either a zygomatic or maxillary osteotomy. The anterolateral thigh adipofascial flap is a reliable choice for large soft tissue deficits in type 4 PRS. We hope that reporting our surgical management algorithm with long-term follow-up results will improve the personalized treatment of these patients.

Comparison of osteogenic capability of 3D-printed bioceramic scaffolds and granules with different porosities for clinical translation.

Pore parameters, structural stability, and filler morphology of artificial implants are key factors influencing the process of bone tissue repair. However, the extent to which each of these factors contributes to bone formation in the preparation of porous bioceramics is currently unclear, with the two often being coupled. Herein, we prepared magnesium-doped wollastonite (Mg-CSi) scaffolds with 57% and 70% porosity (57-S and 70-S) via a 3D printing technique. Meanwhile, the bioceramic granules (57-G and 70-G) with curved pore topography (IWP) were prepared by physically disrupting the 57-S and 70-S scaffolds, respectively, and compared for in vivo osteogenesis at 4, 10, and 16weeks. The pore parameters and the mechanical and biodegradable properties of different porous bioceramics were characterized systematically. The four groups of porous scaffolds and granules were then implanted into a rabbit femoral defect model to evaluate the osteogenic behavior in vivo. 2D/3D reconstruction and histological analysis showed that significant bone tissue production was visible in the central zone of porous granule groups at the early stage but bone tissue ingrowth was slower in the porous scaffold groups. The bone tissue regeneration and reconstruction capacity were stronger after 10weeks, and the porous architecture of the 57-S scaffold was maintained stably at 16weeks. These experimental results demonstrated that the structure-collapsed porous bioceramic is favorable for early-stage osteoconduction and that the 3D topological scaffolds may provide more structural stability for bone tissue growth for a long-term stage. These findings provide new ideas for the selection of different types of porous bioceramics for clinical bone repair.

Statement of Retraction: A new Zn(II) complex: promotion on the reconstruction of oral bone tissue via inducing the dental pulp mesenchymal stem cells differentiation

Statement of Retraction: A new Zn(II) complex: promotion on the reconstruction of oral bone tissue via inducing the dental pulp mesenchymal stem cells differentiation

Fasciocutaneous Free Tissue Transfer in Limb Salvage: Prior Flap as a Split-thickness Skin Graft Donor Site.

Free flap surgery for limb salvage has become the surgical standard for reconstruction of bone and soft tissue with success rates and flap survivals of 94%-95%. The soft tissue defect dictates the technique of coverage. In many cases, multiple techniques of soft tissue coverage are necessary, ranging from myocutaneous and fasciocutaneous free flaps to split-thickness skin grafts (STSGs). It has been shown that fasciocutaneous free flaps are not inferior to muscle flaps in treatment of lower leg limb salvage. Although a complete flap loss is rare, it is not uncommon to have partial flap necrosis, wound dehiscence, or secondary soft tissue defects, necessitating further minor reconstruction, which we call "touch up" skin grafts. In many of these secondary procedures, split thickness skin grafts are sufficient. We have been using the skin portion of the fasciocutaneous free flap as a donor site for harvesting STSGs for quite some time without disadvantages. We believe that minimizing additional donor site morbidity is of great importance. The free tissue transfer is insensate and readily available at the site of injury, making prepping and draping simple as well as cosmetically acceptable, as the transferred free tissue, unfortunately, is rarely a perfect fit. The associated pain, discomfort, and scar of an additional donor site can be avoided. In our case series, we did not experience any flap loss, infections, or complications. Thus, harvesting an STSG from a fasciocutaneous free flap seems to be a feasible option to be considered in limb salvage.

Trade-off between the radiation parameters and image quality using iterative reconstruction techniques in head computed tomography: a phantom study.

Iterative reconstruction techniques (IRTs) are commonly used in computed tomography (CT) and help to reduce image noise. To determine the minimum radiation dose while preserving image quality in head CT using IRTs. The anthropomorphic phantom was used to scan nine head CT image series with varied radiation parameters. CT dose parameters, including volume CT dose index (CTDIvol [in mGy]) and dose length product (DLP [in mGy/cm]), were recorded for each scan series. Different noise levels (iDoseL1-6) were used in IRT reconstructions for soft and bone tissues. In total, 15 measurements were taken from five regions of interest (ROI) with an area of 10 mm2. The signal-to-noise ratio (SNR) and noise values obtained at different ROIs were compared among various reconstruction methods with repeated measures of statistical analysis. In the head CT scan, applying IRT iDoseL5 had the lowest noise and highest SNR for soft tissue (P < 0.05), and increased iDose can decrease CT dose by 54.6% without compromising image quality. While for bone tissue reconstruction, no clear association was found between the level of iDose and noise. However, when CTDIvol is >20 mGy, iDoseL4 is slightly superior to other reconstruction methods (P < 0.065). Using IRTs in head CTs reduces radiation dose while maintaining image quality. IDoseL5 provided optimal balance for soft tissue.

Computed Tomography and 3-D Face Scan Fusion for IoT-Based Diagnostic Solutions

In clinical diagnosis, multimodal medical image fusion is meaningful and necessary, for the reason that some diseases need to be diagnosed in combination with the situation of different tissues of patients. Spiral computed tomography realizes the high-precision and smooth reconstruction of bone tissue, while it can not represent the color and texture information in soft tissue reconstruction with high accuracy. The face scan precisely records the color and shape of the maxillofacial region. The diagnosis of some diseases (like cavernous hemangioma and jaw deformity caused by idiopathic condylar resorption) needs to combine the information of maxillofacial soft tissue and bone, so it is of great significance to fuse spiral CT and face scan images. In this paper, a novel intelligent IoT scene is proposed: a multimodal medical images acquisition and fusion system, and by combining CT machine and face scan equipment, the CT and face scan of patients can be synchronously collected. Deep point neural networks are used to extract feature points and a threshold iterative closest point algorithm performing registration with deep feature points and contributed region segmentation is applied. Finally, high-precision fused modal data is output at the mobile terminal to facilitate diagnosis and analysis and improve the efficiency of doctor-patient communication. Quantitative experiments show promising results, and clinical experiments prove that our method enables patients and doctors to better understand the state of an illness and improves the efficiency of doctor-patient communication.

Surgical Excision and Reconstruction in Oral Cavity Cancer

The primary treatment of oral cavity cancer is still surgery. By discussing the surgical treatment of oral cavity cancer, the basic concept of head and neck surgery could be thoroughly reviewed. The oral cavity is defined as the hard palate and the anterior 2/3 of the tongue. With appropriate reconstruction, most defects can be repaired without a significant change in quality of life, unlike in the oropharynx or hypopharynx, where aspiration problems frequently occur. The selection of a surgical approach that can provide an appropriate field of view to obtain a resection margin of 5 mm or more has become the core of head and neck surgery. The role of prophylactic neck dissection is also well established in oral cavity cancer patients. Mandibulotomy for access to the oral cavity or mandibulectomy due to cancer invasion requires bony surgical techniques, and reconstruction also requires bone tissue reconstruction techniques as well as soft tissue. Therefore, oral cancer surgery is the most important primary area where all techniques of head and neck surgery are mobilized.