Mandibular reconstruction after resection of benign tumours using non‐vascularised methods in a series of patients that did not undergo radiotherapy

Abstract

AbstractAim: A case series analysis of 52 consequent subjects of immediate mandibular reconstruction after tumour resection using non‐vascularised methods, undertaken at U.P. King George's University of Dental Sciences and King George's Medical University, is being reported. To assess the success of reconstruction on subjective and objective evaluation based upon Mandibular Reconstruction Assessment Scale (MRAS) questionnaire.Methods: Patients with benign mandibular tumours irrespective of age, sex, site and socio‐economic status were included. Primary reconstruction was carried out after resection in two surgical units on surgeon's choice using stainless steel wire (6/52; 12%), stainless steel reconstruction plate (10/52; 19%) or titanium reconstruction plate (36/52; 69%) without bone graft (23/52; 44%) or with bone graft (29/52; 56%). Bone grafts were harvested from iliac crest (21/52; 40%), rib (2/52; 4%) and an additional pectoralis major myocutaneous flap with iliac crest bone graft (6/52; 12%) to provide cover to the reconstruction plate was also used.Results: The primary outcome measurements were wound healing, mouth opening, chewing efficiency, jaw movements, cosmetic achievement and speech on a five‐point scale, all of which improved significantly after surgery. The overall complication rate was 17%. Three patients (6%) had loosening of the screw, two (4%) showed dehiscence of the plate, two (4%) showed tumour recurrence and one (2%) had infection of the graft that was subsequently removed.Conclusion: Titanium reconstruction plates with iliac crest graft provided good result in the absence of microvascular reconstruction because of unavailable long operating time and lack of expertise. Long‐term satisfactory rehabilitation can be achieved using removable dentures or prosthesis on dental implants on the contraption provided by the non‐vascularised tissue despite non‐calcified bone visible on the skiagram.