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Italian Journal of Maxillofacial Surgery 2011 April;22(1):47-56


language: English

Mandibular reconstruction using non-vascularized autogenous bone graft applied in decorticated cortical bone

Pramono C.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Airlangga, Surabaya, Indonesia


This article describes the result of a surgical technique of immediate mandibular reconstruction after resection using two types of non-vascularized autogenous bone grafts taken from iliac crest and rib costochondral and the bone graft which were treated with cortical layers decortication before being grafted. Two cases of mandible ameloblastoma and one case of extensive ossifying fibroma suffered in adolescent treated with mandible resection and immediate reconstruction using non-vascularized bone graft. Two patients were reconstructed using rib costochondral grafts and the other two patients received iliac-crest grafts. The cortical bone layers of the bone grafts were first decorticated and followed by splitting longitudinally to expose more its cancellous surfaces before being grafted. The graft rated as successful if it survived beyond 6 months after placement. Follow-up was for at least 12 months postoperatively. Non-vascularized autogenous bone grafts were successfully used for mandible reconstruction after resection in 3 cases. Well-consolidated graft can be seen clearly in panoramic photograph since 5 to 6 months after surgery in three cases. In one case, bone resorption was seen since 4 months postoperatively, lost of periosteum layers due the enlarged tumor mass was suspected to be responsible of this event. Clinically, two cases were presented clearly with solid bone which was seen during dental implant placement in case 1 and reconstruction plate removal in case 3. Bone sample taken from the grafted bone in case 1 and 3 were evaluated histopathologically showed with a matured bone. Non-vascularized autogenous bone graft prepared in decorticated form can be used as an alternative method for immediate mandibular reconstruction after resection in adolescent.

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