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Mandibular reconstruction: bone graft techniques.

W Lawson, H F Biller

    Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
    |September 1, 1982
    PubMed
    Summary
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    Delayed mandibular reconstruction using bone grafts achieved a 91% success rate, significantly outperforming immediate reconstruction (46%). Oral contamination limited immediate repair success.

    Area of Science:

    • Oral and Maxillofacial Surgery
    • Reconstructive Surgery
    • Biomaterials in Medicine

    Background:

    • Mandibular defects require complex reconstruction.
    • Various surgical techniques exist for mandibular restoration.
    • Assessing the efficacy of different reconstruction methods is crucial.

    Purpose of the Study:

    • To compare the success rates of delayed versus immediate mandibular reconstruction.
    • To identify factors influencing the outcome of mandibular reconstruction.
    • To evaluate the reliability of bone grafts in mandible repair.

    Main Methods:

    • Retrospective analysis of 60 patients undergoing mandibular reconstruction.
    • Delayed reconstruction: titanium mesh tray with cancellous bone/block bone grafts (iliac crest, rib, mandible).

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  • Immediate reconstruction: wire mesh prosthesis with particulate bone and composite flaps.

    • Main Results:

    • Delayed reconstruction: 91% success rate in 34 patients.
    • Immediate reconstruction: 46% success rate in 26 patients.
    • Oral contamination identified as a limiting factor for immediate reconstruction success.
    • Block bone grafts via extraoral approach highly reliable for delayed repair.
    • Successful reconstruction achieved even after high-dose radiotherapy.

    Conclusions:

    • Delayed mandibular reconstruction with bone grafts is highly successful.
    • Immediate reconstruction methods show lower success rates, potentially due to contamination.
    • Block bone grafts are reliable for delayed mandibular continuity restoration.
    • Mandibular reconstruction is feasible even in irradiated patients.