title: Reconstruction of mandibular defects - clinical retrospective research over a 10-year period -.
abstract: BACKGROUND
  Functional and cosmetic defects in the maxillofacial region are caused by various ailments and these defects are addressed according to their need. Simplicity of procedure, intact facial function and esthetic outcome with the least possible donor site morbidity are the minimum requirements of a good reconstruction. Oro-mandibular 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. Reconstruction of trauma- or mandibular oncologic defects with bony free flaps is considered the gold standard. However the the optimal reconstruction of mandibular defects is still controversial in regards to reconstructive options which include the donor site selection and the timing of surgery. The purpose of this study was to determine the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstructions.
  
  
  METHODS
  This study was carried out on 178 patients with mandibular bone defects. They were reconstructed with autogenous bone grafts from different donor sites. At post operative visits they were evaluated for functional and cosmetic results.
  
  
  RESULTS
  The success rate found in this study was around 90%. Only 7.6% of the cases showed poor results regarding facial contours and mouth opening. All other patients were satisfied with their cosmesis and mouth opening at the recipient sites was in the normal range during last follow-up visits. Donor sites were primarily closed in all cases and there was no hypertrophic scar.
  
  
  CONCLUSIONS
  Based on this study, autogenous bone grafts are a reliable treatment modality for the reconstruction of mandibular bone defects with predictable aesthetic and functional outcomes. As the free vascularized fibular flap has the least resorption and failure rate, it should be the first choice for most cases of mandiblular reconstruction.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany. rana.majeed@mh-hannover.de
authors.forename: Majeed
authors.initials: M
authors.lastname: Rana
authors.forename: Riaz
authors.initials: R
authors.lastname: Warraich
authors.forename: Horst
authors.initials: H
authors.lastname: Kokemüller
authors.forename: Juliane
authors.initials: J
authors.lastname: Lemound
authors.forename: Harald
authors.initials: H
authors.lastname: Essig
authors.forename: Frank
authors.initials: F
authors.lastname: Tavassol
authors.forename: André
authors.initials: A
authors.lastname: Eckardt
authors.forename: Nils-Claudius
authors.initials: NC
authors.lastname: Gellrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D035843:Biomedical Research; D016025:Bone Transplantation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000002:abnormalities*; D008336:Mandibular Diseases / Q000151:congenital* / Q000453:epidemiology / Q000601:surgery*; D008875:Middle Aged; D057909:Orthognathic Surgery / Q000379:methods / Q000706:statistics & numerical data; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D055815:Young Adult