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RecruitingNCT04098146Updated Sep 4, 2025

Registry to Collect Data on Patients Undergoing Segmental Mandibular Defect Reconstruction Following Oral Squamous Cell Carcinoma Resection and Drugs-induced Osteonecrosis

An observational study in Mandibular Reconstruction and Segmental Mandibular Defects, sponsored by AO Innovation Translation Center. Recruiting at 19 sites in 8 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-09-04.

Sponsored by AO Innovation Translation Center · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
300
Ages
18 Years and older
Sex
All
01

Study summary

Prospective will be collected in a minimum of 300 patients presenting with an acquired segmental mandibular defect ≥ 2 cm secondary to OSSC removal and drugs-induced osteonecrosis, and who require mandibular reconstruction.

Read the detailed description

Data will be prospectively collected from at least 300 patients with acquired segmental mandibular defects of 2 cm or larger following resection of tumors or necrotic/infected tissue, all of whom require mandibular reconstruction.

The follow up (FU) will consist of standard of care (routine) procedures and data collection will be done at 3, 6, 12, 18 and up to 24 months after resection and/or reconstruction. The maximum FU for each patient within the registry will be 2 years after mandibular resection.

Data collection will include confounding baseline data, tumor characteristics, neurological function, patient reported outcomes, quality of life as well as anticipated procedure-related adverse events (AEs). Available images will be collected and evaluated centrally to determine the location, positioning, osseointegration, bone quantity and quality of the transplants.

Depending on the volume and quality of the collected data, different statistical analyses will be performed. Exploratory analyses will be conducted to find relationships between the different treatment modalities and their outcomes.

02

Conditions studied

  • Mandibular Reconstruction
  • Segmental Mandibular Defects

Keywords

  • Mandibular osteotomy
  • Free bone flap
  • Reconstructive surgical procedure
  • Adjuvant Irradiation / Chemotherapy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Sampling method
Probability sample

Study population

Patients presenting with an acquired segmental mandibular defect secondary to oral squamous cell carcinoma removal and who require mandibular reconstruction.

Inclusion criteria

  • The study includes patients with an initial pathological/histologic diagnosis of mandibular involvement by oral tumors (such as OSCC, osteosarcoma, and ameloblastoma), bisphosphonate- or immunomodulatory drug-induced osteonecrosis, and mandibular lesions from metastatic conditions originating from other sites including lung, breast, prostate, or kidney.
  • Age 18 years and older
  • Bisphosphonate related osteonecrosis of the mandible
  • Immunomodulatory drugs induced mandibular osteonecrosis
  • Patients presented with ameloblastoma affecting the mandible
  • Patients presented with osteosarcomas of the mandible
  • Patients presented with oral metastases related mandibular lesions that are indicated for segmental resection, common primary tumor sites include lung, breast, prostate and kidney
  • Undergoing primary curative treatment with segmental resection of the mandible ≥2 cm
  • Intention to undergo mandibular reconstruction with autologous bone using a primary (one-stage) or secondary (two-stage) approach
  • Informed consent obtained, ie:

    • Ability to understand the content of the patient information/ICF
    • Willingness and ability to participate in the clinical investigation according to the registry plan (RP) o Signed and dated IRB/EC approved ICF OR
    • Written consent provided according to the IRB/EC defined and approved procedures for patients who are not able to provide to provide independent written informed consent

Exclusion criteria

Exclusion Criteria:

  • Tumors affecting the condyle
  • Patients under palliative care
  • Previous extensive mandibular surgeries (including reconstructions, e.g., TMJ replacement) that may potentially confound the outcome measures

Intraoperative exclusion criteria:

  • Nonsegmental mandibular defect (eg. box resection/partial resection)
  • Segmental mandibular defect of less than 2 cm
  • Mandibular defects extending beyond the sigmoid notch into the condyles

Additional exclusion criterion:

  • No osseous reconstruction with autologous bone performed within 18 months from resection
04

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
300 participants (estimated)
Target follow-up
2 Years
Patient registry
Yes

Groups and cohorts

  • Mandibular Reconstruction

    Patients undergoing segmental mandibular defect reconstruction. The decision of one stage or two stage reconstruction is done according to the patient and treating surgeon preferences following the local standard of care

    Procedure: Surgical Resection and Reconstruction

Interventions

  • ProcedureSurgical Resection and Reconstruction

    One stage reconstruction: Osseous reconstruction is performed in the same surgery of the tumor/mandibular resection. It is also known as immediate or primary reconstruction. Second stage reconstruction: Osseous reconstruction is performed after the tumor/mandibular resection surgery as an independent surgery. After the mandibular resection a temporary alloplastic bridging might be put in place. It is also known as delayed or secondary reconstruction.

05

What researchers measure

Primary outcomes

  1. Demographics

    Demographics (year of birth, height in cm and weight in kilogram, race)

    Time frame: Baseline until resection surgery approximately 4 weeks

  2. Comorbidities

    Comorbidities assessed by Charlson Comorbidity Index (this score assesses the comorbidity level by considering both the number and severity of predefined comorbidity conditions. It provides a weighted score of a patient's comorbidities which can be used to predict mortality rates

    Time frame: Baseline until resection surgery approximately 4 weeks

  3. Nicotine consumption

    Current and previous nicotine use will be collected: * Number of years * Time (years) since stopped using (if applicable) * Amount of cigarettes/day

    Time frame: Baseline until resection surgery approximately 4 weeks

  4. Patient reported outcome: Oral Health Impact Profile (OHIP)

    Change in the OHIP over the follow-up period. The Oral Health Impact Profile is providing a comprehensive measure of self-reported dysfunction, discomfort and disability attributed to oral conditions. The OHIP is concerned with impairment and three functional status dimensions (social, psychological, and physical). Respondents are asked to indicate on a five-point Likert scale how frequently they experienced each problem. Response categories for the five-point scale are: "Very often", "Fairly often", "Occasionally", "Hardly ever" and "Never". The OHIP consists of 14 questions in which higher scores indicate worse outcomes.

    Time frame: Baseline/ 3months/ 6 months/ 12 months/ 18 months/ 24 months

  5. Difference of tumor locations of the oral squamous cell cancer

    Oral squamous cell carcinoma locations acoording to follwoing regions: * Anterior compartment which includes lower lip, buccal mucosa, anterior vestibule, anterior ridge and anterior floor mouth * Lateral compartment which includes posterior vestibule, posterior alveolar ridge, posterior (lateral) floor of mouth * Retromolar compartment which includes alveolar ridge posterior to last molar, region of wisdom teeth, retromolar triangle ie buccal cheek, soft palate (arch), tonsillar regions * Tongue which includes ventral tongue (undersurface of tongue), lateral rim of tongue, base of tongue

    Time frame: Baseline until resection surgery ( approximately 4 weeks)

  6. Difference of tumor staging according to the TNM system

    Oral squamous cell carcinoma staging according to TNM (Tumor, Node, Metastasis) system. In the TNM system the "T" refers to the size and extent of the main tumor likert from T0 to T4 whereas T0 is the smallest and T4 the biggest size. The main tumor is usually called the primary tumor. The "N" refers to the number of nearby lymph nodes that have cancer likert for N0 to N3 whereas N0 is the single nearby lymphnode and N3 multiple lymphnodes. The "M" refers to whether the cancer has metastasized likert from M0 to M1 whereas M0 is no distant metastasis and M1 is distant metastasis.

    Time frame: Baseline until resection surgery ( approximately 4 weeks)

  7. Difference of surgical duration and hospital stay if resection and reconstruction was performed in one or two stages

    * Duration of surgery (skin to skin) in minutes * Length of hospital stay in days * Date of osseous reconstruction (if different from resection surgery) in days

    Time frame: Day of resection surgery until day of reconstruction surgery up to 18 months

  8. Difference of surgical procedures of osseous reconstruction

    * Numers of Bone and soft tissue flaps to reconstruct the mandible: ie number of pieces in which the donor bone(s) is cut to shape the reconstructed mandible * Type of bone donor/ bone transfer site(s): Vascularized bone flap(s) or composite flaps (ie bone and adjacent soft tissue harvested within the same flap) and type(s)

    Time frame: Day of resection surgery until day of reconstruction surgery up to 18 months

  9. Different surgical parameters of tumor and segmental mandibular resection if VSP planning was used

    * Use of virtual surgical planning (VSP) for resection: Yes/No. * Only virtual planning and simulation of resection (no 3D printing):Yes/No. * 3D-printed biomodels: Yes/No

    Time frame: Day of resection surgery until day of reconstruction surgery up to 18 months

06

Study locations

16 of 19 sites recruiting
  • University of Florida College of Medicine
    Jacksonville, Florida 32209, United States
    Recruiting
  • University of Illinois Chicago
    Chicago, Illinois 60612, United States
    Recruiting
  • Northwell Health Cancer Institute
    New Hyde Park, New York 11042, United States
    • Brett Miles · Contact · bmiles4@northwell.edu · 6462846215
    • Brett Miles · Principal investigator
    • Danielle Scarola · Sub investigator
    Not yet recruiting
  • Mount Sinai Hospital
    New York, New York 10029, United States
    Recruiting
  • John Peter Smith Health Network
    Fort Worth, Texas 76104, United States
    Recruiting
  • Universitätsklinikum Tübingen
    Tübingen, Baden-Wurttemberg 72076, Germany
    Recruiting
  • University Hospital RWTH Aachen
    Aachen, 52074, Germany
    Recruiting
  • University Hospital Charité
    Berlin, 13353, Germany
    Recruiting
  • Hannover Medical School
    Hanover, 30625, Germany
    Recruiting
  • Universitätsklinikum Heidelberg
    Heidelberg, 69120, Germany
    Recruiting
  • University Hospital Leipzig
    Leipzig, 04103, Germany
    Recruiting
  • Klinikum der LMU München
    Munich, 80337, Germany
    Recruiting
  • University Hospital Ulm
    Ulm, 89081, Germany
    Recruiting
  • Shimane University
    Izumo, 693-0001, Japan
    Not yet recruiting
  • Erasmus University Medical Centre
    Rotterdam, 3015 GD, Netherlands
    Recruiting
  • Luz Hospital
    Lisbon, 1500-650, Portugal
    Not yet recruiting
  • 12 de Octubre
    Madrid, 28041, Spain
    Recruiting
  • Uppsala University Hospital
    Uppsala, 75185, Sweden
    Recruiting
  • University Hospital Basel
    Basel, 4031, Switzerland
    Recruiting
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04098146
Lead sponsor
AO Innovation Translation Center
Responsible party
Sponsor
First posted
Sep 23, 2019
Start date
Sep 12, 2022
Primary completion
Jun 30, 2030 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Sep 4, 2025

Study contacts

Maria Medina Giner
Contact
maria.medinaginer@aofoundation.org
0795456120
Marco Minoia, PhD
Contact
marco.minoia@aofoundation.org
Rüdiger Zimmerer, PD, MD
principal investigator · University of Leipzig

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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