Twenty-year follow-up of reconstruction with allogeneic hemimandible and autogenous particulate bone and cancellous marrow

Abstract

This report shows a long-term follow-up of a mandibular reconstruction with a composite graft, consisting of an allogeneic bone crib packed with autogenous particulate bone and cancellous marrow (PBCM). In this patient, segmental mandibulectomy including exarticulation of the temporomandibular joint (TMJ) had been necessary, due to recurrent odontogenic myxoma including the TMJ. Reconstruction was performed with an allogeneic freeze-dried hemimandible with TMJ, packed with compressed autogenous PBCM. Oral rehabilitation was completed with a fixed bridge on two dental implants in the distal part of the graft. During the early follow-up, osteolysis at the mandibular angle and gradual resorption of the temporomandibular joint was observed. Long-term follow-up revealed stable incorporation of the graft with consolidation of defects. A class I occlusion and uninhibited maximum mouth opening remained present. Twenty years after reconstruction with the composite graft, the patient is very satisfied, with high functional success. This implies the composite graft can be a successful treatment option in specific cases of mandibular reconstruction.