Methods of mandibular reconstruction using an intact portion of the ascending ramus are described. The patient was a 71-year-old male, diagnosed as having gingival carcinoma in the left lower molor region.
Preoperative radiation therapy with 60Co (total dose 36 Gy) was administered. Osteoectomy from the first premolar to the region of the angle was performed to enable single piece resection of the tumor.
Under direct observation the bone necessary for reconstruction, about 5-1cm size, was separated from the resected segment of mandible. The mandible was then reconstructed by bridging the gap with the autogenous bone.
No clinical evidence for tumor recurrence was found at 12 months.
Although the patient's left cheek developed a slight depression, occlusion was satisfactory. We therefore feel the method reported is useful for immediate mandibular reconstruction after lower molar excision, providing that the excision does not exceed 5cm in length.