Immediate Reconstruction of Mandibular Defects: A Retrospective Report of 242 Cases

Li, Zubing; Zhao, Yifang; Yao, Sheng; Zhao, Jihong; Yu, Shibin; Zhang, Wenfeng

doi:10.1016/j.joms.2006.06.282

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 5 , Pages 883-890, May 2007

Immediate Reconstruction of Mandibular Defects: A Retrospective Report of 242 Cases

Zubing Li, DDS, PhD
- Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Wuhan, China, and Key Laboratory of Oral Biomedical Engineering (Wuhan University), Ministry of Education, Wuhan, China.
- Address correspondence and reprint requests to Dr Li: Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Key Laboratory of Oral Biomedical Engineering, Wuhan University, Ministry of Education, 237 Luoyu Road, Wuhan, China
Yifang Zhao, DDS, MSc
- Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Wuhan, China, and Key Laboratory of Oral Biomedical Engineering (Wuhan University), Ministry of Education, Wuhan, China.
Sheng Yao, DDS, MSc
- Formerly, Research Associate; and Currently, Resident, Department of Stomatology, First Hospital of Wuhan, Wuhan, China.
Jihong Zhao, DDS, MSc
- Associate Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Wuhan, China, and Key Laboratory of Oral Biomedical Engineering (Wuhan University), Ministry of Education, Wuhan, China.
Shibin Yu, DDS, PhD
- Associate Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Wuhan, China, and Key Laboratory of Oral Biomedical Engineering (Wuhan University), Ministry of Education, Wuhan, China.
Wenfeng Zhang, DDS, MSc
- Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Wuhan, China, and Key Laboratory of Oral Biomedical Engineering (Wuhan University), Ministry of Education, Wuhan, China.

Purpose

This study was conducted to evaluate the effects of routine protocols in immediate mandibular reconstruction.

Patients and Methods

A total of 242 patients who underwent immediate mandibular reconstruction were reviewed retrospectively. The therapeutic evaluation was performed according to outcomes of clinical and radiographic examination. The evaluated contents included facial symmetry, degree of mouth opening, occlusal relationship, and temporomandibular joint symptoms. Statistical analysis was also carried out to compare therapeutic differences between different methods for mandibular reconstruction. SPSS 10.0 for Windows was used for statistical analysis.

Results

The follow-up showed satisfactory long-term outcome in 203 patients. Statistical analysis revealed no significant difference in restoration of facial contour among several groups (χ² 0.05(15) = 21.93; P = .109 > .05). Ten cases involved serious postoperative complications, including local infection, exposure of rigid fixation plate, and serious pain.

Conclusions

Our findings indicate that autogenous bone graft is the best for reconstruction of small mandibular defects. Frozen autogenous lesional mandible plus autogenous iliac or rib graft is recommended for reconstruction of large defects in the mandible. Strict patient selection, careful surgical procedure, and appropriate preoperative and postoperative nursing care are key factors in successful transplantation.