Mandibular segmental reconstruction with iliac crest

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Bone Grafting Techniques

Background:

• Benign destructive lesions of the mandible pose significant reconstructive challenges.
• Traditional methods may have limitations in restoring function and aesthetics.
• The iliac crest is a potential source for autologous bone reconstruction.

Purpose of the Study:

• To evaluate the efficacy of free nonvascularised iliac crest bone grafts for mandibular reconstruction.
• To assess functional and aesthetic outcomes in patients with benign destructive mandibular lesions.
• To determine the suitability of iliac crest grafts for various extents of mandibular defects.

Main Methods:

• Retrospective analysis of 20 patients undergoing mandibular reconstruction with free nonvascularised iliac crest grafts.
• Graft contouring, fixation with stainless steel wire, and maxillomandibular fixation were employed.
• Reconstruction addressed hemimandibulectomy and segmental defects (1-3 segments).

Main Results:

• Successful reconstruction in 19 out of 20 patients, with only one failure.
• Satisfactory mouth opening/closure, mastication, and facial appearance reported.
• Functional deficits noted only in hemimandibulectomy patients without condylar reconstruction.

Conclusions:

• Free nonvascularised iliac crest grafts are a reliable option for mandibular reconstruction.
• This technique is suitable for both hemimandible and long contiguous segment defects.
• The iliac crest offers a viable solution for restoring mandibular form and function.