Skip to main content

Advertisement

Log in

Mandibular Reconstruction: Overview

  • Review Paper
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Introduction

Mandibular reconstruction has changed significantly over the years and continues to evolve with the introduction of newer technologies and techniques.

Purpose

This article reviews the history of oromandibular reconstruction, biomechanics of mandible, summarizes the reconstruction options available for mandible with defect classification, goals in reconstruction, the various donor sites, current reconstructive options, dental rehabilitation and persistent associated problems.

Summary

Oromandibular reconstruction, although a challenge for the head and neck reconstructive surgeon, is now reliable and highly successful with excellent long-term functional and aesthetic outcomes with the use of autogenous bone grafts and current reconstructive options. The ideal reconstruction would provide a solid arch to articulate with the upper jaw, restoring swallowing speech, mastication, and esthetics. Autogenous vascularized bone grafts in combination with microsurgical techniques have revolutionized mandibular reconstruction in oral cancer surgery. Current trends in mandibular reconstruction aim to achieve reestablishment of a viable mandible of proper form and maxillary mandibular relationship while decreasing the need for invasive autogenous graft procurement. However the optimal reconstruction of mandibular defects is still controversial in regards to reconstructive options which include the donor site selection, timing of surgery and method of reconstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Ivy RH (1951) Bone grafting for restoration of defects of the mandible. Plast Reconstr Surg (1946) 7(4):333–341

    Article  CAS  Google Scholar 

  2. Tessier P, Kawamoto H, Matthews D, Posnick J, Raulo Y, Tulasne JF, Wolfe SA (2005) Taking long rib grafts for facial reconstruction: tools and techniques—III. A 2900-case experience in maxillofacial and craniofacial surgery. Plast Reconstr Surg 116(5 Suppl):38S–46S (discussion 92S–94S)

    Article  CAS  PubMed  Google Scholar 

  3. Testelin S (1992) History of microsurgical reconstruction of the mandible. Ann Chir Plast Esthet 37(3):241–245

    CAS  PubMed  Google Scholar 

  4. de Fries HO (1981) Reconstruction of the mandible: use of combined homologous mandible and autologous bone. Otolaryngol Head Neck Surg 89(4):694–697

    Google Scholar 

  5. White S (1909) The employment of silver wire to bridge the gap after resection of a portion of the lower jaw. Br Med J 2(2552):1525

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Lowlicht RA, Delacure MD, Sasaki CT (1990) Allogeneic (homograft) reconstruction of the mandible. Laryngoscope 100(8):837–843

    Article  CAS  PubMed  Google Scholar 

  7. Attie JN, Catania A, Ripstein CB (1953) Stainless steel mesh prosthesis for immediate replacement of hemimandibulectomy. Surgery 33:712

    CAS  PubMed  Google Scholar 

  8. Blocker TC, Stout RA (1949) Mandibular reconstruction. World War II. Plast Reconstr Surg 4:153

    Article  Google Scholar 

  9. Castermans A, Van Garse R, Vanwick R (1977) Primary resection of mandible after resection for oral cancer. Acta Chir Belg 2:205–208

    Google Scholar 

  10. Bowerman JE (1974) A review of reconstruction of the mandible. Proc R Soc Med 67(7):610–614

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Albert TW, Smith JD, Everts E, Cook TA (1980) Dacron mesh tray and cancellous bone in reconstruction of mandibular defects. Arch Otolaryngol Head Neck Surg 8:78–83

    Google Scholar 

  12. Wersäll J, Bergstedt H, Körlof B, Lind MG (1984) Split-rib graft for reconstruction of the mandible. Otolaryngol Head Neck Surg 92:270–275

  13. Taylor GI, Townsend P, Corlett R (1979) Superiority of the deep circumflex iliac vessels as the supply for free groin flaps. Experimental work. Plast Reconstr Surg 64(5):595–604

    Article  CAS  PubMed  Google Scholar 

  14. Swartz WM, Banis Newton JCED (1986) The osteocutaneous scapular flap for mandibular and maxillary reconstruction. Plast Reconstr Surg 77(4):530–545

    Article  CAS  PubMed  Google Scholar 

  15. Hidalgo DA (1989) Fibula free flap: a new method of mandible reconstruction. Plast Reconstr Surg 84(1):71–79

    Article  CAS  PubMed  Google Scholar 

  16. Bradley PF (1982) A two-stage procedure for reimplantation of autogenous freeze-treated mandibular bone. J Oral Maxillofac Surg 40:278

    Article  CAS  PubMed  Google Scholar 

  17. Dong YJ, Zhang GZ, Wang SP, Li Z (1996) The use of immediate frozen autogenous mandible, for benign tumour mandibular reconstruction. Br J Oral Maxillofac Surg 34(1):58–61

    Article  CAS  PubMed  Google Scholar 

  18. Kuo YR, Shih HS, Chen CC et al (2010) Free fibula osteocutaneous flap with soleus muscle as a chimeric flap for reconstructing mandibular segmental defect after oral cancer ablation. Ann Plast Surg 64(6):738–742

    Article  CAS  PubMed  Google Scholar 

  19. Bak M, Jacobson AS, Buchbinder D, Urken ML (2010) Contemporary reconstruction of the mandible. Oral Oncol 46(2):71–76

    Article  PubMed  Google Scholar 

  20. Lin PY, Lin KC, Jeng SF (2011) Oromandibular reconstruction: the history, operative options and strategies, and our experience. ISRN Surg 2011:824251

    Article  PubMed  PubMed Central  Google Scholar 

  21. Misch CE, Qu ZM, Bidez MW (1999) Mechanical properties of trabecular bone in the human mandible: implications for dental implant treatment planning and surgical placement. J Oral Maxillofac Surg 57:700–706

    Article  CAS  PubMed  Google Scholar 

  22. Yi WJ, Heo MS, Lee SS, Choi SC, Huh KH, Lee SP (2007) Direct measurement of trabecular bone anisotropy using directional fractal dimension and principal axes of inertia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:10–116

    Article  Google Scholar 

  23. Jewer DD, Boyd JB, Manktelow RT, Zuker RM, Rosen IB, Gullane PJ et al (1989) Orofacial and mandibular reconstruction with the iliac crest free flap: a review of 60 cases and a new method of classification. Plast Reconstr Surg 84:391–405

  24. Maurer P, Eckert AW, Kriwalsky MS, Schubert J (2010) Scope and limitations of methods of mandibular reconstruction: a long-term follow-up. Br J Oral Maxillofac Surg 48:100–104

  25. Schusterman MA, Harris SW, Raymond AK, Goepfert H (1993) Immediate free flap mandibular reconstruction: significance of adequate surgical margins. Head Neck 15:204

    Article  CAS  PubMed  Google Scholar 

  26. Lawson W, Loscalzo LJ, Baek SM et al (1982) Experience with immediate and delayed mandibular reconstruction. Laryngoscope 92:5

    Article  CAS  PubMed  Google Scholar 

  27. Marx RE, Ames JR (1982) The use of hyperbaric oxygen therapy in bony reconstruction of the irradiated and tissue deficient patient. J Oral Maxillofac Surg 40:410

    Article  Google Scholar 

  28. Marx RE (1993) Mandibular reconstruction. J Oral Maxillofac Surg 51:466

    Article  CAS  PubMed  Google Scholar 

  29. Carlson ER, Monteleone K (2004) An analysis of inadvertent perforations of mucosa and skin concurrent with mandibular reconstruction. J Oral Maxillofac Surg 62:1103

    Article  PubMed  Google Scholar 

  30. Cordeiro PG, Hidalgo DA (1995) Conceptual considerations in mandibular reconstruction. Clin Plast Surg 22:61

    CAS  PubMed  Google Scholar 

  31. Baker A, McMahon J, Parmar S (2001) Immediate reconstruction of continuity defects of the mandible after tumor surgery. J Oral Maxillofac Surg 59:1333

    Article  CAS  PubMed  Google Scholar 

  32. Li X, Zhu K, Liu F, Li H (2014) Assessment of quality of life in giant ameloblastoma adolescent patients who have had mandible defects reconstructed with a free fibula flap. World J Surg Oncol 12:201. doi:10.1186/1477-7819-12-201

    Article  PubMed  PubMed Central  Google Scholar 

  33. Netscher DT, Meade RA, Goodman CM et al (2000) Quality of life and disease specific functional status following microvascular reconstruction for advanced (T3 and T4) oropharyngeal cancers. Plast Reconstr Surg 105:1628

    Article  CAS  PubMed  Google Scholar 

  34. Weymuller EA, Yueh B, Deleyiannis FWB et al (2000) Quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 126:329

    Article  CAS  PubMed  Google Scholar 

  35. Boyd JB, Mullholland RS, Davidson J et al (1995) The free flap and plate in oromandibular reconstruction: long-term review and indications. Plast Reconstr Surg 95:1018

    Article  CAS  PubMed  Google Scholar 

  36. Havlik RJ (1996) Reconstruction of the pediatric mandible. Oper Tech Plastic Reconstr Surg 3(4):272–288. https://www.infona.pl/resource/bwmeta1.element.elsevier-22f19fc2-1ab2-3f4b-8a75-4ed01a222baf

  37. Gullane PJ, Holmes H (1976) Mandibular reconstruction new concept. Arch Otolaryngol Head Neck Surg 112:714–719

    Article  Google Scholar 

  38. Urken ML (1991) Composite free flaps in oro-mandibular reconstruction. Arch Otolaryngol Head Neck Surg 117:724–732

    Article  CAS  PubMed  Google Scholar 

  39. Komisar A (1990) The functional result of mandibular reconstruction. Laryngoscope 100:364–374

    Article  CAS  PubMed  Google Scholar 

  40. Peled M, El-Naaj IA, Lipin Y, Ardekian L (2005) The use of free fibular flap for functional mandibular reconstruction. J Oral Maxillofac Surg 63:220–224

    Article  PubMed  Google Scholar 

  41. Yim KK, Wei FC (1994) Fibula osteoseptocutaneous flap for mandible reconstruction. Microsurgery 15(4):245–249

    Article  CAS  PubMed  Google Scholar 

  42. Haughey BH, Fredrickson JM, Lerrick AJ et al (1994) Fibular and iliac crest osteomuscular free flap reconstruction of the oral cavity. Laryngoscope 104:1305

    Article  CAS  PubMed  Google Scholar 

  43. Vuillemin T, Raveh J, Sutter F (1998) Mandibular reconstruction with the titanium hollow screw reconstruction plate (THORP) system: evaluation of 62 cases. Plast Reconstr Surg 82:804

    Article  Google Scholar 

  44. Schusterman MA, Reece KP, Kroll SS et al (1991) Use of the A–O plate for mandibular reconstruction in cancer patients. Plast Reconstr Surg 88:588–593

    Article  CAS  PubMed  Google Scholar 

  45. Chow J, Hill J (1986) Primary mandibular reconstruction using the A–O reconstruction plate. Laryngoscope 96:768–773

    Article  CAS  PubMed  Google Scholar 

  46. Poswillo D (1974) Experimental reconstruction of the mandibular joint. Int J Oral Surg 3:400

    Article  CAS  PubMed  Google Scholar 

  47. Guyuron B, Lasa C (1992) Unpredictable growth pattern of costochondral graft. Plast Reconstr Surg 90:880–886

    Article  CAS  PubMed  Google Scholar 

  48. Medra AM (2005) Follow up of mandibular costochondral grafts after release of ankylosis of the temporomandibular joints. Br J Oral Maxillofac Surg 43(2):118–122

    Article  PubMed  Google Scholar 

  49. Lata J, Kapila BK (2000) Overgrowth of a costochondral graft in temporomandibular joint reconstructive surgery: an uncommon complication. Quintessence Int 31(6):412–414

    CAS  PubMed  Google Scholar 

  50. Fernandes R, Fattahi T, Steinberg B (2006) Costochondral rib grafts in mandibular reconstruction. Atlas Oral Maxillofac Surg Clin North Am 14(2):179–183

    Article  PubMed  Google Scholar 

  51. Caccamese JF, Ruiz RL, Costello BJ (2005) Costochondral rib grafting. Atlas Oral Maxillofac Surg Clin North Am 13:139–149

    Article  PubMed  Google Scholar 

  52. Hamaker RC (1981) Irradiated autogenous mandibular grafts in primary reconstructions. Laryngoscope 91:1031–1051

    Article  CAS  PubMed  Google Scholar 

  53. Leipzig B, Cummings CW (1984) The current status of mandibular reconstruction using autogenous frozen mandibular grafts. Head Neck Surg 8:992–998

    Article  Google Scholar 

  54. Schmoper RR (1983) Mandibular reconstruction using a special plate: animal experiments and clinical appearance. J Maxillofac Surg 11:99–108

    Article  Google Scholar 

  55. Burwell RG (1964) Studies in transplantation of bone. VII. The fresh composite homograft-autograft of cancellous bone; an analysis of factors leading to osteogenesis in marrow transplants and in marrow-containing bone grafts. J Bone Joint Surg Br 46:110–140

    CAS  PubMed  Google Scholar 

  56. Rappaport I, Boyne PV, Nethery J (1971) The particulate graft in tumor surgery. Am J Surg 122(6):748–755

    Article  CAS  PubMed  Google Scholar 

  57. Boyne PJ (1969) Restoration of osseous defects in maxillofacial casualities. J Am Dent Assoc 78(4):767–776

    Article  CAS  PubMed  Google Scholar 

  58. Leake DL, Rappoport M (1972) Mandibular reconstruction: bone induction in an alloplastic tray. Surgery 72(2):332–336

    CAS  PubMed  Google Scholar 

  59. Cheung LK, Samman N, Tong AC, Tideman H (1994) Mandibular reconstruction with the Dacron urethane tray: a radiologic assessment of bone remodeling. J Oral Maxillofac Surg 52(4):373–380 (discussion 381)

    Article  CAS  PubMed  Google Scholar 

  60. Cheung LK, Samman N, Chow TW, Clark RKF, Tideman H (1997) A bone graft condensing syringe system for maxillofacial reconstructive surgery. Br J Oral Maxillofac Surg 35:267–270

    Article  CAS  PubMed  Google Scholar 

  61. Kinoshita Y, Kobayashi M, Hidaka T, Ikada Y (1997) Reconstruction of mandibular continuity defects in dogs using poly (l-lactide) mesh and autogenic particulate cancellous bone and marrow: preliminary report. J Oral Maxillofac Surg 55(7):718–723 (discussion 723–724)

    Article  CAS  PubMed  Google Scholar 

  62. Louis P, Holmes J, Fernandes R (2004) Resorbable mesh as a containment system in reconstruction of the atrophic mandible fracture. J Oral Maxillofac Surg 62(6):719–723

    Article  PubMed  Google Scholar 

  63. Takagi S, Chow LC, Markovic M, Friedman CD, Costantino PD (2001) Morphological and phase characterizations of retrieved calcium phosphate cement implants. J Biomed Mater Res 58(1):36–41

    Article  CAS  PubMed  Google Scholar 

  64. Samman N, Cheung LK, Tideman H (1996) Functional reconstruction of the jaws: new concepts. Ann R Australas Coll Dent Surg 13:184–192

    CAS  PubMed  Google Scholar 

  65. Tideman H, Samman N, Cheung LK (1998) Functional reconstruction of the mandible: a modified titanium mesh system. Int J Oral Maxillofac Surg 27(5):339–345

    Article  CAS  PubMed  Google Scholar 

  66. Warnke PH, Springer IN, Wiltfang J, Acil Y, Eufinger H, Wehmöller M, Russo PA, Bolte H, Sherry E, Behrens E, Terheyden H (2004) Growth and transplantation of a custom vascularised bone graft in a man. Lancet 364(9436):766–770

    Article  CAS  PubMed  Google Scholar 

  67. Celeste AJ, Iannazzi JA, Taylor RC, Hewick RM, Rosen V, Wang EA, Wozney JM (1990) Identification of transforming growth factor beta family members present in bone-inductive protein purified from bovine bone. Proc Natl Acad Sci USA 87(24):9843–9847

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Moghadam HG, Urist MR, Sandor GK, Clokie CM (2001) Successful mandibular reconstruction using a BMP bioimplant. J Craniofac Surg 12(2):119–127 (discussion 128)

    Article  CAS  PubMed  Google Scholar 

  69. Herford AS, Boyne PJ (2008) Reconstruction of mandibular continuity defects with bone morphogenetic protein-2 (rhBMP-2). J Oral Maxillofac Surg 66(4):616–624

    Article  PubMed  Google Scholar 

  70. Clokie CM, Sándor GK (2008) Reconstruction of 10 major mandibular defects using bioimplants containing BMP-7. J Can Dent Assoc 74(1):67–72

    PubMed  Google Scholar 

  71. Carter TG, Brar PS, Tolas A, Beirne OR (2008) Off-label use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for reconstruction of mandibular bone defects in humans. J Oral Maxillofac Surg 66(7):1417–1425

    Article  PubMed  Google Scholar 

  72. Glied AN, Kraut RA (2010) Off-label use of rhBMP-2 for reconstruction of critical-sized mandibular defects. N Y State Dent J 76(4):32–35

    PubMed  Google Scholar 

  73. Herford AS, Cicciù M (2010) Recombinant human bone morphogenetic protein type 2 jaw reconstruction in patients affected by giant cell tumor. J Craniofac Surg 21(6):1970–1975

    Article  PubMed  Google Scholar 

  74. Hidalgo DA (1991) Aesthetic improvements in free-flap mandible reconstruction. Plast Reconstr Surg 88(4):574–585 (discussion 586–587)

    Article  CAS  PubMed  Google Scholar 

  75. Hidalgo DA, Rekow A (1995) Review of 60 consecutive fibula free flap mandible reconstructions. Plast Reconstr Surg 96:585

    Article  CAS  PubMed  Google Scholar 

  76. Frodel JL Jr, Funk GF, Cappis DT et al (1993) Osseointegrated implants: a comparative study of bone thickness in four vascularized bone flaps. Plast Reconstr Surg 92:449–455

    Article  PubMed  Google Scholar 

  77. Kuriloff DB, Sullivan MJ (1991) Mandibular re-construction using vascularized bone graft. Otolaryngol Clin North Am 24:1391–1418

    CAS  PubMed  Google Scholar 

  78. O’Leary MJ, Martin PJ, Hayden RE (1994) The neurocutaneous free fibula flap in mandibular reconstruction. Otolaryngol Clin North Am 27(6):1081–1096

    PubMed  Google Scholar 

  79. Chim H, Salgado CJ, Mardini S, Chen HC (2010) Reconstruction of mandibular defects. Semin Plast Surg 24(2):188–197

    Article  PubMed  PubMed Central  Google Scholar 

  80. Gilbert A (1981) Free vascularized bone grafts. Int Surg 66(1):27–31

    CAS  PubMed  Google Scholar 

  81. Wol KD, Ervens J, Herzog K, Hoefmister B (1996) Experience with the osteocutaneous fibula flap: an analysis of 24 consecutive reconstructions of composite mandibular defects. J Cranio-Maxillofac Surg 24:330–338

    Article  Google Scholar 

  82. Goodacre TE, Walker CJ, Jawad AS, Jackson AM, Brough MD (1990) Donor site morbidity following osteocutaneous free fibula transfer. Br J Plast Surg 43(4):410–412

    Article  CAS  PubMed  Google Scholar 

  83. Thoma A, Levis C, Young JE (2005) Oromandibular reconstruction after cancer resection. Clin Plastic Surg 32(3): 361–375

  84. Soutar DS, Widdowson WP (1986) Immediate reconstruction of the mandible using a re-vascularized segment of radius. Head Neck Surg 8(4):232–246

  85. Jaquet Y et al (2012) Radial forearm free flap donor site morbidity ulnar-based transposition flap vs. split-thickness skin graft. Arch Otolaryngol Head Neck Surg 138(1):38–43

    Article  PubMed  Google Scholar 

  86. Rockwell GM, Thoma A (2004) Should the donor radius be plated prophylactically after harvest of a radial osteocutaneous flap? A cost-effectiveness analysis. J Reconstr Microsurg 20:297–306

    Article  PubMed  Google Scholar 

  87. Cummings (1995) Discuss the options for mandibular reconstruction in lateral and anterior arch defects (non-vascularized vs. vascularized bone grafts). Sem Surg Oncol 11:190

    Article  Google Scholar 

  88. Baker SR, Sullivan MJ (1988) Osteocutaneous free scapular flap for one stage mandibular reconstruction. Arch Otolaryngol Head Neck Surg 114:267–277

    Article  CAS  PubMed  Google Scholar 

  89. Urken ML, Buchbinder D, Weinberg H et al (1989) Primary placement of osseointegrated implants in microvascular mandibular reconstruction. Otolaryngol Head Neck Surg 101:58–73

    Google Scholar 

  90. Sullivan MJ et al (1990) The free scapular flap for head and neck reconstruction. Am J Otolaryngol 11:319–327

    Article  Google Scholar 

  91. Lueg E (2004) The anterolateral thigh flap: radial forearm’s “big brother” for extensive soft tissue head and neck defects. Arch Otolaryngol Head Neck Surg 130:813–818

    Article  PubMed  Google Scholar 

  92. Wei FC, Jain V, Celik N et al (2002) Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109:2219–2226

    Article  PubMed  Google Scholar 

  93. Yu P (2004) Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck 26:759–769

    Article  PubMed  Google Scholar 

  94. Walton RL (1993) Discussion. Free anterolateral thigh flaps for reconstruction of head and neck defects. Plast Reconstr Surg 92:429–430

    Article  Google Scholar 

  95. Wei FC, Jain V, Suominen S et al (1988) Confusion among perforator flaps: What is a true perforator flap? Plast Reconstr Surg 81:561

    Article  Google Scholar 

  96. Koshima I (2000) Discussion. Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation. Plast Reconstr Surg 105:2358–2360

    Article  PubMed  Google Scholar 

  97. Rajan R (1997) The pectoralis major myocutaneous flap in head and neck reconstruction. Indian J Otolaryngol Head Neck Surg 49(4):368–373

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. McLeod AM, Robinson DW (1982) Reconstruction of defects involving the mandible and floor of mouth by free osteocutaneous flaps derived from the foot. Br J Plast Surg 35:239–248

    Article  Google Scholar 

  99. Urken ML, Buchbinder D, Costantino PD et al (1998) Oromandibular reconstruction using microvascular composite flaps: report of 210 cases. Arch Otolaryngol Head Neck Surg 124(1):46–55

    Article  CAS  PubMed  Google Scholar 

  100. Manchester WM (1972) Some technical improvements in the reconstruction of the mandible and temporomandibular joint. Plast Reconstr Surg 50(3):249–256

    Article  CAS  PubMed  Google Scholar 

  101. Urken ML, Vickery C, Weinberg H, Buchbinder D, Lawson W, Biller HF (1989) The internal oblique-iliac crest osteomyocutaneous free flap in oromandibular reconstruction. Report of 20 cases. Arch Otolaryngol Head Neck Surg 115(3):339–349

    Article  CAS  PubMed  Google Scholar 

  102. Rogers SN, Lakshmiah SR, Narayan B et al (2003) A comparison of the long-term morbidity following deep circumflex iliac and fibula free flaps for reconstruction following head and neck cancer. Plast Reconstr Surg 112(6):1517–1525

    Article  PubMed  Google Scholar 

  103. Ramasastry SS, Tucker JB, Swartz WM et al (1984) The internal oblique muscle flap: an anatomic and clinical study. Plast Reconstr Surg 73:721–730

    Article  CAS  PubMed  Google Scholar 

  104. Seikaly H, Calhoun K, Rassekh C, Slaughter D (1997) The clavipectoral osteomyocutaneous free flap. Otolaryngol Head Neck Surg 117(5):547–554

    Article  CAS  PubMed  Google Scholar 

  105. Milroy BC, Korula P (1988) Vascularized innervated transfer of the clavicular head of the pectoralis major muscle in established facial paralysis. Ann Plast Surg 20:273–282

    Article  Google Scholar 

  106. Reid CD, Taylor GI, Waterhouse N (1986) The clavicular head of pectoralis major musculocutaneous free flap. Br J Plast Surg 39:57–65

    Article  CAS  PubMed  Google Scholar 

  107. Seikaly H, Chau J, Li F, Driscoll B, Seikaly D, Calhoun J, Calhoun KH (2003) Bone that best matches the properties of the mandible. J Otolaryngol 32(4):262–265

    Article  PubMed  Google Scholar 

  108. Pogrel MA, Podlesh S, Anthony JP et al (1997) A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofac Surg 55:1200–1206

    Article  CAS  PubMed  Google Scholar 

  109. Granström G, Jacobsson M, Tjellström A (1992) Titanium implants in irradiated tissue: benefits from hyperbaric oxygen. Int J Oral Maxillofac Implants 7:15–25

    PubMed  Google Scholar 

  110. Marx RE (1983) A new concept in the treatment of osteoradionecrosis. J Oral Maxillofac Surg 41:351–357

    Article  CAS  PubMed  Google Scholar 

  111. AleAlam DS, Nuara M, Christian J (2009) Analysis of outcomes of vascularized flap reconstruction in patients with advanced mandibular osteoradionecrosis. Otolaryngol Head Neck Surg 141:196–201

    Article  Google Scholar 

  112. Dufresne C, Cutting C, Valauri F et al (1987) Reconstruction of mandibular and floor of mouth defects using the trapezius osteomyocutaneous flap. Plast Reconstr Surg 79:687–696

    Article  CAS  PubMed  Google Scholar 

  113. Hirsch DL, Bell RB, Dierks EJ et al (2008) Analysis of microvascular free flaps for reconstruction of advanced mandibular osteoradionecrosis: a retrospective cohort study. J Oral Maxillofac Surg 66:2545–2556

    Article  PubMed  Google Scholar 

  114. Foley BD et al (2013) Mandibular reconstruction using computer-aided design and computer-aided manufacturing: an analysis of surgical results. J Oral Maxillofac Surg 71(2):e111–e119

    Article  PubMed  Google Scholar 

  115. Costantino PD, Shybut G, Friedman CD, Pelzer HL, Masini M, Shindo ML, Sisson GA Sr (1990) Segmental mandibular regeneration by distraction osteogenesis: an experimental study. Arch Otolaryngol Head Neck Surg 116:535–545

    Article  CAS  PubMed  Google Scholar 

  116. Costantino PD, Johnson CS, Friedman CD, Sisson GA (1995) Bone regeneration within a human segmental mandible defect: a preliminary report. Am J Otolaryngol 16:56–65

    Article  CAS  PubMed  Google Scholar 

  117. Herford AS (2004) Use of a plate-guided distraction device for transport distraction osteogenesis of the mandible. J Oral Maxillofac Surg 62:412–420

    Article  PubMed  Google Scholar 

  118. González-García R, Naval-Gías L (2010) Transport osteogenesis in the maxillofacial skeleton: the outcomes of a versatile reconstruction method following tumor ablation. Arch Otolaryngol Head Neck Surg 136:243–250

    Article  PubMed  Google Scholar 

  119. Malawer MM, Chou LB (1995) Prosthetic survival and clinical results with use of large segment replacements in the treatment of high-grade bone sarcomas. J Bone Joint Surg Am 77:1154–1165

    CAS  PubMed  Google Scholar 

  120. Riede U, Luem M, Ilchmann T, Eucker M, Ochsner PE (2007) The M.E Müller straight stem prosthesis: 15 year follow-up. Survivorship and clinical results. Arch Orthop Trauma Surg 127:587–592

    Article  PubMed  Google Scholar 

  121. Tideman H, Lee S (2006) The TL endoprosthesis for mandibular reconstruction—a metallic yet biological approach. Asian J Oral Maxillofac Surg 18:5

    Article  Google Scholar 

  122. Lee S, Goh BT, Tideman H, Stoelinga PJ, Jansen JA (2009) Modular endoprosthesis for mandibular body reconstruction: a clinical, micro-CT and histologic evaluation in eight Macaca fascicularis. Int J Oral Maxillofac Surg 38:40–47

    Article  CAS  PubMed  Google Scholar 

  123. Goh BT, Lee S, Tideman H, Stoelinga PJ (2009) Replacement of the condyle and ascending ramus by a modular endoprosthesis in Macaca fascicularis part 1: a clinical and radiographic study. J Oral Maxillofac Surg 67:1392–1400

    Article  PubMed  Google Scholar 

  124. Wong RC, Tideman H, Merkx MA, Jansen J, Goh SM (2012) The modular endoprosthesis for mandibular body replacement. Part 2: finite element analysis of endoprosthesis reconstruction of the mandible. J Craniomaxillofac Surg 40:e487–e497

    Article  PubMed  Google Scholar 

  125. Gronthos S (2004) Reconstruction of human mandible by tissue engineering. Lancet 9436:735–736

    Article  Google Scholar 

  126. Warnke PH, Wiltfang J, Springer I, Acil Y, Bolte H, Kosmahl M et al (2006) Man as living bioreactor: fate of an exogenously prepared customized tissue-engineered mandible. Biomaterials 17:3163–3167

    Article  CAS  Google Scholar 

  127. Warnke PH, Springer IN, Acil Y, Julga G, Wiltfang J, Ludwig K et al (2006) The mechanical integrity of in vivo engineered heterotopic bone. Biomaterials 7:1081–1087

    Article  CAS  Google Scholar 

  128. Heliotis M, Lavery KM, Ripamonti U, Tsiridis E, di Silvio L (2006) Transformation of a prefabricated hydroxyapatite/osteogenic protein-1implant into a vascularised pedicled bone flap in the human chest. Int J Oral Maxillofac Surg 3:265–269

    Article  Google Scholar 

  129. Boyne PJ (1971) Transplantation, implantation and grafts. Dent Clin North Am 15:433–453

    CAS  PubMed  Google Scholar 

  130. Blake F, Bubenheim M, Heiland M et al (2008) Retrospective assessment of the peri-implant mucosa of implants inserted in reanastomosed or free bone grafts from the fibula or iliac crest. Int J Oral Maxillofac Implants 23:1102–1108

    PubMed  Google Scholar 

  131. Rohner D, Jaquiery C, Kunz C, Bucher P, Maas H, Hammer B (2003) Maxillofacial reconstruction with prefabricated osseous free flaps: a 3-year experience with 24 patients. Plast Reconstr Surg 112:748–757

    Article  PubMed  Google Scholar 

  132. Marunick MT, Roumanas ED (1999) Functional criteria for mandibular implant placement post resection and reconstruction for cancer. J Prosthet Dent 82(1):107–113

    Article  CAS  PubMed  Google Scholar 

  133. Mücke T, Hölzle F, Loeffelbein DJ, Ljubic A, Kesting M, Wolff KD, Mitchell DA (2011) Maxillary reconstruction using microvascular free flaps. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(1):51–57. doi:10.1016/j.tripleo.2010.03.042

    Article  PubMed  Google Scholar 

  134. Garrett N, Roumanas ED, Blackwell KE, Freymiller E, Abemayor E, Wong WK, Gerratt B, Berke G, Beumer J 3rd, Kapur KK (2006) Efficacy of conventional and implant-supported mandibular resection prostheses: study overview and treatment outcomes. J Prosthet Dent 96(1):13–24

    Article  PubMed  Google Scholar 

  135. Raoul G, Ruhin B, Briki S, Lauwers L, Haurou Patou G, Capet JP, Maes JM, Ferri J (2009) Microsurgical reconstruction of the jaw with fibular grafts and implants. J Craniofac Surg 20(6):2105–2117. doi:10.1097/SCS.0b013e3181bec611

    Article  PubMed  Google Scholar 

  136. Salinas TJ, Desa VP, Katsnelson A, Miloro M (2010) Clinical evaluation of implants in radiated fibula flaps. J Oral Maxillofac Surg 68(3):524–529. doi:10.1016/j.joms.2009.09.104

    Article  PubMed  Google Scholar 

  137. Foster RD, Anthony JP, Sharma A, Pogrel MA (1999) Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: an outcome analysis of primary bony union and endosseous implant success. Head Neck 21(1):66–71

    Article  CAS  PubMed  Google Scholar 

  138. Weischer T, Mohr C (1999) Ten-year experience in oral implant rehabilitation of cancer patients: treatment concept and proposed criteria for success. Int J Oral Maxillofac Implants 14(4):521–528

    CAS  PubMed  Google Scholar 

  139. Werkmeister R, Szulczewski D, Walteros-Benz P, Joos U (1999) Rehabilitation with dental implants of oral cancer patients. J Craniomaxillofac Surg 27(1):38–41

    Article  CAS  PubMed  Google Scholar 

  140. Shaw RJ, Sutton AF, Cawood JI, Howell RA, Lowe D, Brown JS, Rogers SN, Vaughan ED (2005) Oral rehabilitation after treatment for head and neck malignancy. Head Neck 27(6):459–470

    Article  PubMed  Google Scholar 

  141. Sclaroff A, Haughey B, Gay WD, Paniello R (1994) Immediate mandibular reconstruction and placement of dental implants at the time of ablative surgery. Oral Surg Oral Med Oral Pathol 78(6):711–717

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Batchu Pavan Kumar.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kumar, B.P., Venkatesh, V., Kumar, K.A.J. et al. Mandibular Reconstruction: Overview. J. Maxillofac. Oral Surg. 15, 425–441 (2016). https://doi.org/10.1007/s12663-015-0766-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-015-0766-5

Keywords

Navigation