Evaluation of Bone Resorption Rate after Nonvascularized Iliac Bone Graft for Mandibular Discontinuity Defect

Choi, Jin Wook; Lee, Chung O; Hwang, Hee Don; Kim, Jin Wook; Kwon, Tae Geon; Kim, Chin Soo; Lee, Sang Han

Abstract

PURPOSE
Mandible resection and discontinuity defect created lead to aesthetic and functional problems. The iliac crest bone graft exhibits relative ease for bone harvesting, possibility of two team approach, ability to close the wound primarily, large amount of corticocancellous bone and relatively few complications. Whereas the use of free vascularized flaps has donor site morbidity and worse-fitting bone contour, the use of nonvascularized iliac bone graft has advantages in the operation time and patients' recovery time. So, nonvascularized iliac bone graft could be an attractive option.
METHODS
Twenty-one patients (M:F=1:1.1) underwent iliac crest bone harvesting for reconstruction of mandibular discontinuity defect (mean length : 61.6+/-17.8 mm), from May 2005 to October 2011 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University. The average age was 44.1+/-16.4 years and the mean follow up periods was 28.2+/-22.7 months. Bone resorption rate, according to age, sex, primary lesion, location and distance of defect, type of fixation plate, time of graft and pre-operative radiation therapy, were measured in each patient.
RESULTS
The mean bone resorption rate was 16.1+/-9.0%. Bone resorption rate was significantly increased in mandibular defect that is over 6 cm in size (P=0.015, P<0.05) and the cases treated pre-operative radiation therapy (P=0.017, P<0.05). All was successfully fixed and maintained for the long-term follow-up. There were a few donor site complications and almost all patients were shown favorable outcome without severe bone resorption in this study.
CONCLUSION
The nonvascularized iliac bone graft seems to be a reasonably reliable treatment option for reconstruction of mandibular discontinuity defects.