Iliac crest bone grafting for mandibular reconstruction: 10-year experience outcomes

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Bone Grafting

Background:

• Mandibular defects require complex reconstruction.
• Nonvascularized iliac crest bone grafts (NVBG) are a common option.
• Evaluating long-term outcomes is crucial for optimizing surgical techniques.

Purpose of the Study:

• To assess the 10-year efficacy of NVBG for mandibular reconstruction.
• To identify factors influencing reconstruction success and complications.
• To provide evidence-based recommendations for NVBG use in mandibular defects.

Main Methods:

• Retrospective analysis of 60 patients undergoing mandibular reconstruction with NVBG.
• Classification of defects into continuity (CD) and non-continuity (NCD).
• Analysis of various factors including defect size, pathology, and surgical approach; success defined by graft maintenance and absence of infection.

Main Results:

• High success rates: 87% for CD and 82.1% for NCD.
• Defect size significantly impacted success; defects >9 cm were associated with failure.
• Complications were predominantly minor (43 cases) versus major (4 cases).

Conclusions:

• NVBG is highly successful for non-cancerous mandibular continuity defects <9 cm.
• For defects >9 cm, NVBG is less predictable but can be considered with adjunctive materials.
• Symphysis involvement did not significantly affect success rates when following established protocols.