THE IMPORTANCE OF MANDIBULAR POSITION IN MICROVASCULAR MANDIBULAR RECONSTRUCTION

The challenge of mandibular reconstruction rests in the difficulty of re-creating the intricate three-dimensional relationship of the oral c avity, thereby ensuring occlusal relationships, oral competence, and f acial contour. Recent advances in microvascular surgery have made reli able transfer of autologous tissue possible, but successful reconstruc tion depends on accurate insetting of the bone flap. The authors revie wed their five years of experience with mandibular reconstruction and found six patients with a poor reconstructive result secondary to impr oper insetting of the bone flap. Anteromedially rotated and free-float ing proximal mandibular segments appeared to be the most significant c ontributor to incorrect placement of the bone flap. Based on their fin dings, the authors devised a simple technique for stabilizing proximal mandibular segments.