[Bone reconstruction after resection of the mandible for osteoradionecrosis (author's transl)]

Resection of the sections of the mandibular affected by osteoradionecrosis has completely modified the progression and prognosis of this affection by ensuring that the patient does not have to suffer long periods of pain and suppuration, constantly observed when medical treatment is used alone. Unfortunately, these resections are usually extensive and are themselves responsible for functional and esthetic sequelae supported with difficulty by some patients, especially in the case of bilateral or mandibular arch resections. All efforts must be made, therefore, to limit the consequences, and with this in mind it is possible: -- to perform an uninterrupted resection limited to the alveolar area involved, in early cases of mandibular osteoradionecrosis; -- to reconstitute mandibular continuity with a bone graft in more advanced stages; -- to improve the esthetic appearance with skin and subcutaneous grafts whenever this is necessary. Good results can only be obtained if certain anatomical conditions exist and if surgical precautions are adapted to each case.