Evaluation of the mandible as an alternative autogenous bone source for oral and maxillofacial reconstruction

The objective of this study was to quantify the amount of bone graft material present in the different regions of the mandible while avoiding the inferior alveolar neurovascular bundle, mental foramen and tooth injury. The study was carried out on 16 samples of dry, cadaverous skull. The dimensions of the anterior part of ascending ramus, mandibular symphysis and mandibular body in these samples were evaluated. The osteotomy lines in the anterior part of the ascending ramus were made in front of the mandibular canal from the mandibular notch to 3 mm posterior of the root of the third molar. The osteotomy line in the mandibular body was made just medial to the external oblique ridge from the ascending ramus to approximately 3 mm posterior to the mental foramen. Vertical osteotomy lines were then made from the cut ends of the first osteotomy down to the lower border of the mandible. The osteotomy lines in the mandibular symphysis were performed on the mandible with 5-mm safety margins caudal to the expected position of the mandibular dentition, anterior to the position of the mental foramen, and cephalad to the inferior border of the mandible. It was determined that the dimensions of the anterior part of the ascending ramus were 37.60 mm x 33.17 mm x 22.48 mm x 9.15 mm, and the thickest part of the graft material was 12.23 mm. The average horizontal length of the mandibular body bone was 35.10 mm, and the average vertical length was 19.13 mm. The dimensions of the bone graft obtained from the mandibular symphysis were 45.36 mm x 10.31 mm, and the average thickness was 9.63 mm. Based on the results of this study, it is apparent that the different regions of the mandible can reliably be selected as the harvest site in a variety of oral and maxillofacial reconstructive procedures.