Outcome of Mandibular Reconstruction Using Non-Vascularized Block Iliac Bone Graft

Document Type : Original Article

Authors

1 The Departments of General Surgery, Faculty of Medicine, Assiut University, Egypt and Maxillofacial Surgery, King Fahd Specialist Hospital, Buraydah, Saudi Arabia

2 The Department of Maxillofacial Surgery, King Fahd Specialist Hospital, Buraydah, Saudi Arabia**

3 The Department of Maxillofacial Surgery, King Fahd Specialist Hospital, Buraydah, Saudi Arabia

Abstract

Objectives: The purpose of this study was to investigate
the degree of success of nonvascularized block iliac bone
graft for mandibular reconstruction, one year post-operative.
Methods: Sixty-nine patients with segmental mandibular
resection, reconstructed by nonvascularized iliac bone grafts,
were evaluated both clinically and radiologically one year
after mandibular reconstruction.
Results: Thirty-five patients showed complete bone healing,
thirty patients showed bone healing with complications,
and four patients showed total graft necrosis.
Conclusion: Non-vascularized iliac bone graft seems to
be a reliable reconstructive option for mandibular defects up < br />to 7cm in size.

Keywords

Main Subjects


1- Johannes T.M., Robert J.J., Ellen M. and Ron K.: Nonvascularized
bone graft for segmental reconstruction of
the mandible a reappraisal. J. Oral Maxillofacial Surg.,
67: 1446-52, 2009.
2- Akinbami B.O.: Reconstruction of continuity defects of
the mandible with nonvascularized bone grafts. Systematic
literature review. Craniomaxillofac. Trauma Reconstr.,
9: 195-205, 2016.
3- Agrawal A., Mehrotra D., Mohammad S., Singh R.K.,
Kumar S. and Pal U.S.: Randomized control trial of nonvascularized
fibular and iliac crest graft for mandibular
reconstruction. J. Oral Biol. Craniofac. Res., 2: 90-6,
2012.
4- Hanasono M.M.: Reconstructive surgery for head and
neck cancer patients. Adv. Med., 2014: 795483, 2014.
5- Akbay E. and Aydogan F.: Reconstruction of isolated
mandibular bone defects with nonvascularized corticocancellous
bone autograft and graft viability. Auris Nasus
Larynx, 41: 56-62, 2014.
6- Verrier S., Alini M., Alsberg E., Buchman S.R., Kelly D.,
Laschke M.W., Menger M.D., Murphy W.L., Stegemann
J.P., Schütz M., Miclau T., Stoddart M.J. and Evans C.:
Tissue engineering and regenerative approaches to improving
the healing of large bone defects. Eur. Cell Mater,
32: 87-110, 2016.
7- August M., Tompach P. and Chang Y.: Factors influencing
the long-term outcome of mandibular reconstruction. J.
Oral Maxillofac. Surg., 58: 731-737, 2000. [PubMed]
[Google Scholar].
8- Pogrel M.A., Podlesh S. and Anthony J.P.: A comparison
of vascularized and non-vascularized bone grafts for
reconstruction of mandibular continuity defects. J. Oral
Maxillofacial Surg., 55: 1200-1206, 1997. [PubMed]
[Google Scholar].
9- Van Gemert J.T.M., van Es R.J.J., Van Cann E.M. and
Koole R.: Nonvascularized bone grafts for segmental
reconstruction of the mandible-a reappraisal. J. Oral
Maxillofacial Surg., 67: 1446-1452, 2009. [PubMed]
[Google Scholar].
10- Boyd J.B., Mulholland R.S. and Davidson J.: The free
flap and plate in oromandibular reconstruction: Longterm
review and indications. Plast. Reconstr. Surg., 95: 1018-
1028, 1995. [PubMed] [Google Scholar].
11- Mehta R.P. and Deschler D.G.: Mandibular reconstruction
in 2004: An analysis of different techniques. Curr. Opin.
Otolaryngol. Head Neck Surg., 12: 288-93, 2004.
12- Kurz L.T., Garfin S.R. and Booth R.E. Jr.: Harvesting
autogenous iliac bone grafts. A review of complications
and techniques. Spine (Phila Pa 1976). Dec. 14 (12):
1324-31, 1989.
13- Obiechina A.E., Ogunlade S.O., Fasola A.O. and Arotiba
J.T.: Mandibular segmental reconstruction with iliac crest.
West Afr. J. Med., 22; (1): 46-9, 2003.
14- Bai X.F., Wushou A., Zheng J. and Li G.: An alternative
approach for mandible reconstruction. J. Craniofac. Surg.,
Mar. 24 (2): e195-8, 2013.
15- Guerrier G., Alaqeeli A., Al Jawadi A., Foote N., Baron
E. and Albustanji A.: Reconstruction of residual mandibular
defects by iliac crest bone graft in warwounded Iraqi
civilians, 2006-2011. Br. J. Oral Maxillofac. Surg., Jul.,
53 (6): e27-31, 2015.
16- Akbay E. and Aydogan F.: Reconstruction of isolated
mandibular bone defects with non-vascularized corticocancellous
bone auto-graft and graft viability. Auris Nasus
Larynx, 41: 65-62, 2014.
17- Holtz G.: Reconstruction of mandibular discontinuity
defects with delayed non-vascularized free iliac crest
bone grafts and endosseous implants: A clinical report.
J. Prosthet Dent, 76: 350-5, 1996.
18- Foster R.D., Anthony J.P., Sharma A. and Pogrel M.A.:
Vascularized bone flaps versus non-vascularized bone
grafts for mandibular reconstruction: An outcome analysis
of primary bony union and endosseous implant success.
Head Neck, 21: 66-71, 1999.
19- Maurer P., Eckert A.W., Kriwalsky M.S. and Schubert J.:
Scope and limitations of methods of mandibular reconstruction:
A long-term follow-up. Br. J. Oral Maxillofac.
Surg., 48: 100-4, 2010.
20- Gadre P.K., Ramanojam S., Patankar A. and Gadre K.S.:
Nonvascularized bone grafting for mandibular reconstruction:
myth or reality? J. Craniofac. Surg., 22: 1727-35,
2011.
21- Vu D.D. and Schmidt B.L.: Quality of life evaluation for
patients receiving vascularized versus nonvascularized
bone graft reconstruction of segmental mandibular defects.
J. Oral Maxillofac. Surg., 66: 1856-1863, 2008.
22- Mooren R.E., Merkx M.A., Kessler P.A., Jansen J.A. and
Stoelinga P.J.: Reconstruction of the mandible using
preshaped 2.3-mm titanium plates, autogenous cortical
bone plates, particulate cancellous bone, and platelet-rich
plasma: A retrospective analysis of 20 patients. J. Oral
Maxillofac Surg., Oct. 68 (10): 2459-67, 2010.
23- Ndukwe K.C., Aregbesola S.B., Ikem I.C., Ugboko V.I.,
Adebiyi K.E., Fatusi O.A., et al.: Reconstruction of
mandibular decfects using nonvascularized autogenous
bone graft in Nigerians. Niger J. Surg., 20: 87-91, 2014.
24- El-Sheikh M.M., Zeitoun I.M. and Medra A.M.: The split
rib bundle graft in mandibularreconstruction. J. Craniofac.
Surg., 20: 326-332, 1992.
25- Chiapasco M., Colletti G., Romeo E., Zaniboni M. and-
Brussati R.: Long-term results of mandibular reconstruction
with autogenous bone grafts and oral implants after
tumor resection. Clin. Oral Implants Res., 19: 1074-1080,
2008.
272 Vol. 46, No. 3 / Mandibular Reconstruction Using Non-Vascularized Block Iliac Bone Graft
26- Handschel J., Naujoks C., Langenbach F., Berr K., Depprich
R.A., Ommerborn M.A., Kubler N.R., Brinkmann
M., Kogler G. and Meyer U.: Comparison of ectopic bone
formation of embryonic stem cells and cord blood stem
cells in vivo. Tissue Eng. Part A, 16: 2475-2483, 2010