Related Experiment Video
Updated: Feb 12, 2026

A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Bony Union in Maxilla and Mandible Free Flap Reconstruction: A Systematic Review and Meta-Analysis
Khanh Linh Tran1, Zora Heer1, Harkaran Singh Dial1
1Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Background:
Bony nonunion is an important complication in head and neck reconstruction, but its definition, incidence, and treatment are not well-reported.
Methods:
MEDLINE, Embase, CENTRAL, and Web of Science were searched from October 1st, 1990 to January 6th, 2025 for studies reporting bony union for maxilla or mandible reconstruction with vascularized free flap.
Results:
The search strategy yielded 5985 abstracts and 52 were included in the review. Definitions of bony nonunion varied and were reported in 20 studies. Higher pooled rates of complete union were observed in reconstructions of the maxilla, reconstructions using the radius, and surgeries aided by virtual surgical planning. Treatment for nonunion was reported in 11 studies.
Conclusions:
Virtual surgical planning has the potential to improve union outcomes and reduce the need for revision surgeries in nonunion cases. The heterogeneity of the studies necessitates randomized controlled trials for further analysis of the nonunion risk factors and consequences.
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