[Long-term results of mandibular reconstruction with avascular spongiosa transfer and titanium mesh]

Severe and mild complications could only be detected in damaged transplant bed (radical operation and radiation exposure, traumatic lesions) in osteoplastic reconstruction of the mandible with avascular cancellous bone transfer using a titanium carrier. Altogether, we rate this method as more favorable compared to an avascular block transplant because of advantages in handling the system in the surgical technique, contouring of the problem zones in the chin and mandibular angle region, more simple transplant extraction and greater resistance to infections. Owing to the high osteogenic potency of the cancellous bone, a relatively slight tendency to secondary absorption was found. We hence still value avascular cancellous bone transfer as a method which can be recommended for reconstruction of small and medium-size mandibular defects (up to about 6 cm) in good to moderate transplant bed. At present, we restrict vascularized transfer of the cortico-cancellous block transplant to larger mandibular defects and transplant beds which are not ideal for substitution after radical operation and radiation exposure.