Reconstruction of Mandibular Defects

Abstract

Surgical reconstruction of mandibular bone defects is a routine procedure for rehabilitation of patients with deformities caused by trauma, infection or tumor resection. The mandible plays a major role in masticatory and phonetic functions, supporting the teeth and defining the contour of the lower third of the face. Therefore, mandibular discontinuity produces se‐ vere cosmetic and functional deformities, including loss of support for suprahyoid muscles and subsequent airway reduction. Reconstruction of these severe defects is mandatory for restoring the patient’s quality of life. Surgical techniques have improved considerably in the last decade, but reconstruction of large bone defects of the mandible still pose a great chal‐ lenge in maxillofacial rehabilitation. Several things can be done to optimize the surgery; the use of prototyping modeling for instance provides a better assessment of the bone defect and pre-contouring of the fixation plates, reducing operating time. The choice of the most suitable titanium plate system is critical to the success of the procedure. Mandibular defects with loss of continuity require more robust (load bearing) systems supporting mandibular function. Many studies consider the use of plates and screws temporary treatment due to the large number of complications such as fracture of plates and screws, plate exposure and infection. Thus, the use of grafts both in the first operation or in a two-stage procedure en‐ sures a more predictable result.