J Korean Assoc Oral Maxillofac Surg.  2014 Dec;40(6):272-277. 10.5125/jkaoms.2014.40.6.272.

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

• Omeje K
• Efunkoya A
• Amole I
• Akhiwu B
• Osunde D

• KMID: 1799560
• DOI: http://doi.org/10.5125/jkaoms.2014.40.6.272

Abstract

OBJECTIVES
Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions.
MATERIALS AND METHODS
A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review.
RESULTS
Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean 26.0+/-10.6 years). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG.
CONCLUSION
NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.

Keyword

Mandibular resection; Mandibular reconstruction; Non-vascularized iliac crest bone graft

MeSH Terms

Ameloblastoma
Humans
Jaw
Jaw Cysts
Mandibular Reconstruction*
Medical Records
Nigeria
Osteogenesis, Distraction
Osteosarcoma
Retrospective Studies
Tertiary Care Centers
Transplants*

Figure

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  Fig. 1 Preoperative photograph of a 17-year-old boy with mandibular ameloblastoma.

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  Fig. 2 The iliac crest exposed and vertical stops placed bilaterally at the required length.

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  Fig. 3 Harvested bone transposed to recipient bed, secured and the cortical surface oriented buccally in a similar patient.

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  Fig. 4 Postoperative photograph of same patient in Fig. 1 following mandibular resection and reconstruction with non-vascularized iliac crest bone graft.

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  Fig. 5 Postoperative radiograph of same patient in Fig. 1 one year after reconstruction with nonvascularized iliac crest bone graft.

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