Successful reconstruction of 15-cm segmental defects by bone marrow stem cells and resected autogenous bone graft in central hemangioma.

摘要

Central hemangioma of the jaw is a relatively rare lesion and is difficult to manage because of the rich collateral circulation in the region. Surgery and embolization have constituted the treatment mode most often used for central hemangioma, However, radical resection of the jaw causes esthetic disturbance and dysfunction of the mastication system. This report describes a successful reconstruction, by use of a tissue engineering approach, performed in a 14-year-old boy with 15-cm defects after segmental mandibu-lectomy of the central hemangioma. After 7 months of segmental mandibulectomy, osteogenic-differentiated autogenous bone marrow stem cells (BMSCs) and fibrin glue (a vehicle) were injected into a resected autogenous graft as a tray during the first surgery, vertical distraction osteogenesis (DO) was performed during the second surgery, and guided bone regeneration (GBR) and implantation were performed during the third reconstructive surgery. This case shows that tissue engineering by use of autogenous BMSCs and fibrin glue allows successful regeneration in large segmental defects of the jaw.