Joshua Segal, DDS, MD

Feinstein Institute for Medical Research

Joshua Segal

Reconstruction of a Segmental Mandibular Defect Using the Induced Membrane Technique

Following graduation from Northwestern University with a bachelor's degree in biology, Dr. Segal performed two years of developmental neuroscience research at the Children’s Memorial Institute for Education and Research.  He then earned a DDS degree from Stony Brook University School of Dental Medicine.  He completed his Oral and Maxillofacial Surgery residency at Long Island Jewish Medical Center during which time he earned an MD degree from Stony Brook University School of Medicine.  Following residency, Dr. Segal has dedicated himself to resident education in the field of Oral and Maxillofacial Surgery, serving as associate residency director at Brookdale Hospital Medical Center and now at Long Island Jewish Medical Center - Northwell Health.

Abstract:

Segmental defects of the mandible can result from a myriad of traumatic and pathologic conditions.  Various treatment modalities have been advocated for the reconstruction of these defects in order to restore both function and aesthetics.  Reconstructive options include vascularized bone grafts, nonvascularized bone grafts, distraction osteogenesis and utilization of exogenous osteogenic factors. The induced membranes technique is a biphasic technique for the treatment of infected post-traumatic long-bone defects.  The first stage involves placement of a poly-methylmethacrylate cement spacer into the defect. Following a specified time period, a second surgery is performed where the spacer is removed and replaced with autogenous cancellous graft. The foreign body reaction caused by the presence of the cement spacer induces a granulation tissue-type membrane that both maintains the physical space for subsequent graft material, and has significant osteogenic potential.  We propose to evaluate the osteogenic potential of this technique when applied to the rat mandibular model.  This research aims to determine the feasibility of this technique for reconstruction of human mandibular segmental defects.

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