Non-vascularized bone grafting for immediate reconstruction of mandibular defects during benign tumour surgery

Abstract

Reconstruction of mandible is often cited as a challenge in modern maxillofacial surgery. Considering the anatomical and functional attributes, it is obvious that reconstructive techniques for mandible are both technically demanding to perform and a challenge for the surgeon. The goals of mandibular reconstruction are restoration of both form and function, which involves duplication of bone form and volume, achievement of optimum primary fixation and stability to facilitate rapid bone regeneration, reproduction of pre-existing jaw relationship, adequate movement and soft tissue support and the provision of dental implants for rehabilitation. An en-bloc principle of tumour excision with a healthy margin followed by reconstruction of the created either marginal or segmental defect is respected in surgical management of benign jaw lesions. Different methods of autogenous bone grafting in mandibular reconstruction including non-vascularized, vascularized with flap, revascularized by microsurgical technique have been demonstrated with their advantages and disadvantages for over 100 years. Considering the merits and demerits of reconstruction an appropriate immediate reconstruction with non-vascularized bone grafting can produce excellent early aesthetic and functional rehabilitation. This study presents the quality of non-vascularized corticocancellous bone grafting in immediate reconstruction of mandibular defects after excision of benign tumour in 33 cases with 88% success.