Non-Vascularized Bone Grafting for Segmental Mandibular Reconstruction After Oral Cancer Resection: A Systematic...

Area of Science:

• Oral and Maxillofacial Surgery
• Oncology
• Regenerative Medicine

Background:

• Reconstruction of mandibular defects post-oncologic resection presents challenges, especially with compromised recipient beds due to radiation or soft tissue loss.
• The effectiveness of non-vascularised bone grafts (NVBG) in these complex cases is debated.

Purpose of the Study:

• To systematically review and meta-analyze the outcomes of NVBG for segmental mandibular defects following oral cancer resection.
• To compare NVBG outcomes against vascularised free flaps or no reconstruction.

Main Methods:

• A comprehensive literature search was conducted up to June 30, 2025.
• Eleven studies with 202 NVBGs were included, assessing graft integration, complications, function, and aesthetics.
• A meta-analysis compared graft failure rates between irradiated and non-irradiated NVBG recipients.

Main Results:

• The overall graft uptake success rate was 80.4% across included studies.
• Meta-analysis of 4 studies showed a pooled odds ratio of 2.83 for graft failure in irradiated vs. non-irradiated groups (P=0.12), indicating no statistically significant difference.
• A trend towards higher failure in irradiated patients was observed, but based on very low-quality evidence.

Conclusions:

• NVBG can achieve a notable success rate in mandibular reconstruction after oral cancer surgery.
• Current evidence does not statistically support a significant difference in NVBG failure rates between irradiated and non-irradiated patients, despite a trend.
• Further high-quality research is needed to clarify the role of NVBG in irradiated mandibles.