Mandibular defect reconstruction with nonvascularized iliac crest bone graft

Area of Science:

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

Background:

• Mandibular defects present significant functional and esthetic challenges for head and neck surgeons.
• Reconstruction often requires complex surgical approaches.
• The use of nonvascularized iliac crest bone grafts is explored as a viable option.

Purpose of the Study:

• To report the experience with nonvascularized iliac crest bone grafts for mandibular reconstruction.
• To evaluate the outcomes and complications of this technique at University College Hospital, Ibadan, Nigeria.

Main Methods:

• A retrospective descriptive study was conducted.
• Included cases of mandibular reconstruction using iliac crest bone grafts between 2001 and 2007.
• Graft fixation methods included stainless steel wire or titanium plates.

Main Results:

• 47 patients underwent reconstruction with nonvascularized iliac crest bone grafts.
• 10 patients (21.3%) experienced persistent graft infection, exclusively in those with transosseous wire fixation.
• Infected grafts showed polymicrobial isolates, with 60% requiring removal and 40% managed by drainage.

Conclusions:

• Nonvascularized iliac crest bone grafting is an affordable and technically less demanding option for mandibular reconstruction.
• The technique demonstrates potential for successful outcomes, particularly in resource-limited settings.
• Transosseous wiring fixation may be associated with a higher risk of postoperative infection compared to titanium plates.