Grafting a mandibular discontinuity defect via a tunnel approach: report of case

According to Bell, "the aim of bone grafting is to place a readily vascularizable osteogenic organic structure in intimate contact with a vascular osteogenic cancellous host bed." To accomplish these objectives, a tunneling procedure was developed. This technique provided a circumferentially intact vascular bed, which minimized the edema usually caused by interference with venous and lymphatic drainage. Together with adequate graft stabilization and maxillomandibular fixation, this surgical approach deceased shearing forces, permitted unimpeded capillary ingrowth, minimized hematoma and dead-space formation, and maximized the viability of the graft.