Abstract
Reconstruction of segmentally resected mandible using nonvascularized autogenous iliac bone secured with A-O reconstruction plate was performed in 26 patients. Primary reconstruction was performed in 12 patients, and secondary reconstruction in 14 patients. Grafted bone was bicortical, containing the outer and inner plates of the iliac crest, in 22 patients and was monocortical, containing the inner plate, in 4 patients. The sizes of the grafted bones ranged from 3.2cm to 13.0cm in length and from 1.0cm to 2.5cm in height. The follow-up period ranged from 1 year 8 months to 18 years 10 months. Resorption of bone height in the grafted region was calculated using panoramic radiographs based on the size of the reconstruction plate. The average resorption rate was 13.0% of the original height in the bicortical grafts and 26.2% in the monocortical grafts. Reconstruction plates were removed at about 1 year postgraf ting in most patients. Resorption of the grafted bone occurred during the 1-year fixation period. Prolonged fixation did not, however, affect the resorption rate, except in the patient who received the longest graft (13.0cm) in this series. For the bicortical grafts, resorption rate showed no significant difference between primary and secondary reconstruction. The postsurgical complications were nonunion in 2 patients, fracture in 2 patients and infection in 3 patients including total removal in 1 patient. Bicortical grafts shorter than 9 cm are recommended, irrespective of the timing of reconstruction.
