Reconstruction of mandibular defects with composite autologous iliac bone and freeze-treated allogeneic rib grafts

Abstract

Results of five successful cases of mandibular defect reconstruction with composite particulate autologous iliac bone and freeze-treated allogeneic rib grafts are presented. The formation of a water-tight soft tissue seal between the grafting bed and the oral cavity, complete hemostasis, elimination of dead space around the bone graft, and preservation of the periosteum are factors of cardinal importance in improving the success rate with such grafts. By use of this procedure, the amount of autologous bone required is reduced, and the rib acts as a supporting device that is completely resorbed in about a year after implantation. In the postoperative period, the danger of infection is reduced, and the need for subsequent surgical removal of the alloplastic tray is eliminated.