title: [Clinical research of resection of mandibular benign tumors and primary reconstruction with autogenous bone graft via an intraoral approach].
abstract: OBJECTIVE
  To investigate the clinical outcomes of resection of mandibular benign tumors and primary reconstruction with autogenous bone graft via an intraoral approach.
  
  
  METHODS
  Fifteen patients with mandibular benign tumors were treated between January 2009 and September 2012. There were 7 males and 8 females, aged from 18 to 45 years (mean, 30 years). The pathological diagnosis identified 11 cases of ameloblastoma, 3 cases of odontogenic keratocyst, and 1 case of odontogenic myxoma. According to the Urken's CRBS (Condyle, Ramus, Body, Symphysis) classification criteria based on the location of the mandibular defect, there were 3 cases of body type (B type), 3 cases of ramus type (R type), and 9 cases of body and ramus type (BR type). The surgeries were performed via an intraoral approach, except 1 patient with the lesion at the level of sigmoid notch via an auxiliary preauricular incision. To fix the bone grafts to the dissected mandibular defects, reconstructive titanium plates were used, either indirectly according to the computer aided design/computer aided manufacturing mandibular models before surgery (9 patients) or directly according to the exposed mandibles during surgery (6 patients). The patients received benign mandibular tumor resection and primary autogenous bone graft reconstruction with free iliac bones (11 cases) or vascularized fibular flaps (4 cases). The mandibular inferior alveolar nerves were preserved in 6 cases.
  
  
  RESULTS
  Primary healing of incision was obtained in 14 patients, while secondary healing in 1 patient suffering from bone graft infection. All the patients were followed up 1-4 years (mean, 2.5 years). At last follow-up, no patients showed facial nerve damage; occlusion of remaining teeth was similar to preoperative conditions; the chewing function was satisfactory; mouth opening was 30-35 mm (mean, 33 mm); and swallowing and speaking functions were normal. Only slight extraoral scars caused by the auxiliary incision and the transbuccal appliances were observed, and all the patients were satisfied with the facial appearance. Lower lip numbness was relived in patients with preserved inferior alveolar nerves. There was no tumor recurrence during follow-up period.
  
  
  CONCLUSIONS
  The intraoral approach is a feasible and proper approach for resection of benign mandibular tumors and primary reconstruction with autogenous bone grafts, with the advantages of inconspicuous facial scars, minimum damage to the facial nerve, and expectable aesthetic appearance.
authors.forename: Xu
authors.initials: X
authors.lastname: Huang
authors.forename: Jianhua
authors.initials: J
authors.lastname: Liu
authors.forename: Huiming
authors.initials: H
authors.lastname: Wang
authors.forename: Huiyong
authors.initials: H
authors.lastname: Zhu
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Li
authors.forename: Lisong
authors.initials: L
authors.lastname: Teng
mesh_terms: D000293:Adolescent; D000328:Adult; D000564:Ameloblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D063168:Mandibular Osteotomy; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult