Volume 8 Issue 11 (November, 2020)

Original Articles

Reconstruction of continuity defects of the mandible with non-vascularized bone grafts- Original study
Dr. Shreshth Sharma, Dr. Sachin S. Hotkar, Dr. Ashish B. Matne, Dr. Krishna vallabhaneni SS, Dr. Achyuth Ravipati, Dr. Ankita Khandelwal

Aim: The purpose of the study was to assess the success of using non- vascularized bone grafts in mandibular continuity defects. Methodology: The inclusion criteria were patients who had received NVBGs, such as anterior or posterior iliac crest and costochondral grafts, to reconstruct segmental defects of the mandible. Patients with a history of irradiation of the head and neck and patients with inadequate follow-up were excluded from this study. Success was judged by radiographic and clinical evidence of bone continuity and stability at a minimum of 4months postoperatively. Failures were considered loss of all or part of the graft, resulting in a residual continuity defect requiring further bone grafting. Results: We identified 21 potential cases, of which 16 met the inclusion and exclusion criteria. The mean age of the patients at the time of grafting was 42 years (range, 17 to 81 years), with a mean follow-up length of 18 months. The length of defects ranged from 2 to 22 cm. The grafts were 6 cm or less in length in 7 defects and greater than 6 cm in length in 22 defects. All cases were grafted at a minimum of 6 months after resection, and bone morphogenetic protein was used in 5 cases (86%). Failure occurred in 1 patient in the group with grafts of 6 cm or less and 2 patients in the group with grafts greater than 6 cm, corresponding to success rates of 86% and 91%, respectively. Conclusion: The results of our study show that NVBGs are a viable, safe, and effective treatment option for segmental mandibular defects over 6 cm in length in non-irradiated patients. Keywords non-vascularized bone grafts, bone morphogenic protein, mandibular reconstruction.

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