We reviewed the records of 27 patients who underwent primary mandibula
r reconstruction with AO plates to investigate the outcome and complic
ations of this procedure. Immediate soft-tissue flap coverage was requ
ired in 26 patients. Early complications were seen in 44% of the patie
nts, with the highest incidence after irradiation (P = 0.02). Late com
plications were mostly related to tumor recurrence (12). Late complica
tions not associated with recurrence were persistent pain (2), minor i
nfections (3), plate exposure (3), and plate fracture (1). Good to exc
ellent cosmetic results were obtained in all but 1 patient. Full masti
cation was not possible for any of our patients, and therefore functio
n was not fully restored. Speech and deglutition were mostly influence
d by the amount of soft-tissue resection. Mean follow-up was 20 months
(range 3 to 52). At last evaluation, 12 patients were alive and free
of disease, and 15 were dead of disease or other causes. Our results s
how that primary mandibular reconstruction with rigid plates is a safe
, effective, and reliable technique to restore mandibular continuity a
nd cosmesis. For lateral defects, this method is a viable, alternative
to free vascularized osseocutaneous naps.