Abstract

Objectives: Jawbone defects following cystectomy for cysts of the jaw may cause postoperative complications such as pathological fractures and secondary infections. Therefore, different bone-grafting procedures have been developed. Novel cotton-like bone graft material composed of β-tricalcium phosphate, poly-L-lactic acid, and polyglycolic acid (β-TCP/PLLA/PGA) has handling properties, three-dimensional shapeability, and bone forming ability, and has potential clinical utility for bone formation. However, no studies have evaluated the clinical outcomes of the novel β-TCP/PLLA/PGA in patients of oral and maxillofacial surgery. Thus, we evaluated the usefulness of β-TCP/PLLA/PGA in bone formation within jawbone defects following cystectomy. Patients and Methods: 28 patients (19 males and 9 females; mean age: 47.5 years) who visited the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, between November 2022 and April 2024 were included. They underwent cystectomy for cysts of the jaw (maxilla or mandible) and were grafted with β-TCP/PLLA/PGA. All excised cyst were submitted for histopathological examination. Patient demographics, clinical data, and computed tomography (CT) images were retrospectively evaluated to assess the defect dimensions, CT values, and bone continuity of the jawbone defects. Data on postoperative complications were obtained from medical records. Results: Among the 28 cystic lesions (6 maxillary and 22 mandibular jaw cases), 27 were odontogenic cysts (26 odontogenic cysts and 1 orthokeratinized odontogenic cyst), and 1 was a non-odontogenic cyst (nasopalatine duct cyst). Both long- and short-axis lengths of the jawbone defect revealed a significant decrease at 6 months postoperatively compared with the preoperative and 1-month postoperative values. The CT values were significantly increased from 1 month to 6 months postoperatively (P<0.05). At 6 months postoperatively, 39.3% of the patients achieved full bone continuity. No serious adverse events were observed. Conclusion: β-TCP/PLLA/PGA demonstrated excellent handling characteristics and clinical safety as a novel cotton-like bone graft material for jawbone defects following cystectomy.