Reconstruction of large mandibular and surrounding soft-tissue defects using distraction with bone transport

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Plastic Surgery

Background:

• Large bone and soft-tissue defects in the lower face present significant reconstructive challenges.
• Existing surgical techniques may require multiple interventions and can lead to donor site morbidity.
• Restoring both aesthetic and functional outcomes is paramount for patient well-being.

Purpose of the Study:

• To evaluate the outcomes of osteogenic distraction with bone transport for reconstructing extensive mandibular and soft-tissue defects.
• To assess the efficacy and safety of this technique in a clinical setting.
• To determine the potential for oral rehabilitation with dental implants following reconstruction.

Main Methods:

• A retrospective study of 14 patients treated between 2001 and 2008.
• Utilized osteogenic distraction with bone transport for mandibular reconstruction.
• Assessed soft tissue reconstruction, complication rates, and dental implant outcomes.

Main Results:

• Successful soft tissue reconstruction in all patients.
• Mean mandibular bone reconstruction of 13.6 cm over a mean distraction period of 2.3 months.
• No infections occurred; two cases of non-union were treated with iliac bone grafts.
• 57.1% of patients with sufficient bone height received dental implants, with high success rates for activated implants.
• Six patients achieved satisfactory oral rehabilitation with implant-supported prostheses.

Conclusions:

• Osteogenic distraction with bone transport is a viable option for reconstructing large mandibular and soft-tissue defects.
• The technique allows for restoration of oral function and acceptable facial appearance.
• It enables patients to achieve a reasonable quality of life, with potential for successful dental rehabilitation.