3 DIFFERENT TECHNIQUES FOR MANDIBULAR RECONSTRUCTION AFTER HEMIMANDIBULECTOMY

Mandibular reconstruction is a condition in which both bone defect and function must be restored. A wide range of approaches - from grafts t o distant bone flaps - have been used for correcting bony defects. How ever, adequate mastication has been restored in only a few cases. In t his article the results of three different techniques for mandibular r econstruction after hemimandibulectomy were studied. Sixteen patients underwent a second mandibular reconstruction after hemimandibulectomy and were monitored at least 1 year. Three different techniques were us ed: (1) full-thickness galeoparietal bone flap (eight patients), (2) f ree iliac crest graft (three patients), and (3) free fibular grafts (f ive patients). Occlusion on the nonoperated side and the possibility a nd function of osseointegrated denture in the vascularized bone transf er were evaluated. The full-thickness galeoparietal flap and free ilia c crest bone flap appeared to be good options; However, only acceptabl e or poor occlusion could be achieved on the normal side. The fibular free flap demonstrated good results and good occlusion. Nonetheless, d ental implantation was difficult because a prosthesis for reaching the normal height of the mandible was necessary.