Your browser doesn't support javascript.
loading
Nonvascularized bone grafts for segmental reconstruction of the mandible--a reappraisal.
van Gemert, Johannes T M; van Es, Robert J J; Van Cann, Ellen M; Koole, Ron.
  • van Gemert JT; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, The Netherlands. j.t.m.vangemert@umcutrecht.nl
J Oral Maxillofac Surg ; 67(7): 1446-52, 2009 Jul.
Article en En | MEDLINE | ID: mdl-19531416
ABSTRACT

PURPOSE:

To evaluate the success rate and complications of segmental mandibular reconstructions with autogenous nonvascularized iliac crest bone grafts, and to refine treatment strategies. PATIENTS AND

METHODS:

Seventy-four patients with segmental mandibular defects were included. Malignant lesion, immediate reconstruction, smoking habit, radiotherapy, site of the defect, surgical approach, and method of graft fixation were analyzed as factors of influence on success. Success was defined as maintenance of bone continuity and stability, and absence of infection 1 year after reconstruction upon clinical and radiographic examination. Complications were divided into recipient and donor-site complications and classified as minor or major. The reconstruction was considered functionally complete if prosthetic rehabilitation was accomplished or if there was a sufficient remaining dentition for mastication.

RESULTS:

In 56 (76%) patients, the initial reconstruction was successful. Multivariate analyses showed that symphyseal involvement (SI) and intraoral approach (IA) were significantly associated with failure (P(SI) = .022, P(IA) = .038) and major recipient-site complications (P(SI) = .022, P(IA) = .038). Thirty-two (43%) patients showed complications in the first postoperative year 27 recipient-site complications and 6 donor-site complications. Nineteen (70%) recipient-site complications were classified as major. The reconstruction was functionally complete in 48 (86%) of the 56 patients with a successful initial reconstruction.

CONCLUSIONS:

Nonvascularized iliac crest bone grafts for segmental reconstruction of the mandible is the method of choice on the condition that the defect is truly lateral and only an extraoral approach is used. In these cases, microvascular tissue transfer is not necessary.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neoplasias Mandibulares / Trasplante Óseo / Procedimientos Quirúrgicos Orales / Procedimientos de Cirugía Plástica / Mandíbula Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Idioma: En Año: 2009 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neoplasias Mandibulares / Trasplante Óseo / Procedimientos Quirúrgicos Orales / Procedimientos de Cirugía Plástica / Mandíbula Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Idioma: En Año: 2009 Tipo del documento: Article