Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review
L B Moura1, P H de A Carvalho1, C B Xavier1
1Oral and Maxillofacial Surgery Residency Program, School of Dentistry Pelotas, University Hospital at the Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Summary
Non-vascularized bone grafts show an 87.6% success rate for mandibular reconstruction, particularly for benign tumors. However, success rates are lower for defects caused by malignant tumors treated with radiation therapy.
Area of Science:
- Oral and Maxillofacial Surgery
- Regenerative Medicine
- Oncology
Background:
- Mandibular bone defects present significant reconstruction challenges.
- Non-vascularized bone grafts are a common treatment modality.
- Evidence supporting their efficacy requires systematic evaluation.
Purpose of the Study:
- To systematically review the scientific evidence for using non-vascularized bone grafts in mandibular reconstruction.
- To assess the success rates and complications associated with this technique.
Main Methods:
- Systematic literature review of PubMed, Scopus, and Cochrane databases.
- Inclusion of 25 articles detailing 926 reconstruction procedures.
- Analysis of defect causes, graft sources, and complication rates.
Main Results:
- Iliac crest grafts were most common (76.1%).
- Benign tumors (56.8%) were the primary cause of defects, often in the lateral mandible (44.7%).
- Overall success rate was 87.6%, despite a high complication rate (33.3%).
Conclusions:
- Non-vascularized bone grafts are a viable option for mandibular reconstruction, especially for benign defects.
- Malignant tumors treated with radiation therapy appear to be a contraindication due to lower success rates.
- Further standardized clinical studies are needed to refine treatment choices.
Keywords:
autologous transplantationbone transplantationgraft rejectiongraft survivalmandiblereconstructive surgical procedure
