Treatment of Comminuted Fracture Using Titanium Mesh and Biphasic Calcium Phosphate Ceramic Scaffold in Canine
Reconstruction and fixation of bilateral mandibular fracture required a good dental occlusion and normal mastication function after the healing. Several techniques have been reported in canine. However, there is no consensus method for fixation of comminuted fracture of the mandible when dealing with bone loss.
To study the feasibility of using titanium mesh and biphasic calcium phosphate ceramic scaffold (BCP) in fixation of the comminuted fracture of canine mandibles.
A canine patient with bilaterally comminuted fracture of the mandibles was presented to the Kasetsart University Veterinary Teaching Hospital for treatment. The CT images were obtained and preprocessed to construct the 3D image of the skull. The images were transferred to rapid prototyping machine to create a resin skull model for surgical planning. Titanium meshes and 2-mm titanium miniplates were reshaped and contoured to match the morphology of the resin mandibles. Both implants were used to neutralize tensile and compression forces of the mandible during mastication. For each mandibular ramus, the 2-mm miniplate and screws were placed along the alveolar border onto the tension surface. The ventral border of each mandible was stabilized using titanium mesh and screw fixation to counteract compression force. The BCP scaffolds were filled in areas of bone loss underneath the titanium meshes.
There were no postoperative complications detected. Clinical bone healing was obtained with excellent dental occlusion and normal mastication function within 6 months period.
Titanium mesh and biphasic calcium phosphate ceramic scaffold can be utilized in fixation of the comminuted fracture of canine mandible.