Abstract
In our department, we have performed mandibular reconstruction using autogenous particulate cancellous bone and marrow (PCBM) harvested from the posterior iliac crest and a custom-made titanium mesh tray for extended mandibular defects caused by tumor resection and so on. However, harvesting PCBM from the posterior iliac crest has a disadvantage of postural changes during surgery. On the other hand, we can safely and easily harvest a sufficient quantity of PCBM from the tibia.
The patient was a 56-year-old man who underwent immediate mandibular reconstruction using PCBM harvested from the tibia and a custom-made titanium mesh tray after segmental mandibular resection for an extended odontogenic keratocyst in the right mandible. We could harvest approximately 50 g (approx. 49 mL) of PCBM from the unilateral tibia and achieve successful mandibular reconstruction with a natural configuration. Finally, the bone quality of the reconstructed mandible become good. Eleven months later, dental implant placement was performed, and the final occlusal reconstruction with a bone-anchored bridge was completed. The postoperative course has been functionally and aesthetically uneventful for 5 years after mandibular reconstruction. In addition, there were no complications, such as gait disturbance associated with PCBM harvested from the tibia.
