[Free nonvascularized bone graft evolution after mandibular resections: 45 cases report]

Area of Science:

• Oral and Maxillofacial Surgery
• Oncology
• Reconstructive Surgery

Context:

• Benign mandibular tumors frequently necessitate surgical resection and subsequent reconstruction.
• Ameloblastoma is a common benign tumor requiring extensive mandibular resection.
• Reconstruction methods aim to restore function and morphology after tumor removal.

Purpose:

• To evaluate the middle and long-term outcomes of free non-vascularized bone grafting for mandibular reconstruction.
• To analyze the efficacy and complications associated with iliac bone grafts in 45 patients.
• To assess functional and morphological results following hemimandibulectomy and reconstruction.

Summary:

• Forty-five patients underwent resection of benign mandibular tumors, primarily ameloblastoma, followed by reconstruction using free non-vascularized iliac bone grafts.
• The most common procedure was type III hemimandibulectomy (58%), often requiring a combined surgical approach.
• The primary reconstruction technique involved cortico-cancellous iliac grafts fixed with screws and plates, with intermaxillary fixation (95%).
• Mean follow-up was 4.5 years, with 40% demonstrating good osteointegration and satisfactory functional and morphological outcomes.
• Major complications included infection (9 cases) and bone resorption (9%), which were often interrelated and led to poor outcomes in 4 cases.

Impact:

• This study provides valuable insights into the long-term efficacy and potential complications of non-vascularized bone grafting in mandibular reconstruction.
• Findings can inform surgical decision-making and patient counseling regarding the risks and benefits of this reconstructive approach.
• Highlights the need for strategies to mitigate infection and bone resorption to improve patient outcomes.