title: Is immediate reconstruction of the mandible with nonvascularized bone graft following resection of benign pathology a viable treatment option?
abstract: OBJECTIVE
  The purpose of this study was to address the following clinical question: Is immediate reconstruction of the mandible with a nonvascularized bone graft after resection of benign pathology a viable treatment option? Another purpose was to determine whether any variables affect the success of this treatment approach.
  
  
  METHODS
  The authors implemented a retrospective cohort study from a sample of patients diagnosed with a benign tumor of the mandible who were treated with segmental resection and primary reconstruction with an autogenous nonvascularized bone graft. The predictor variables were age, gender, lesion size, and diagnosis, and the outcome variable was graft success determined by re-establishment of mandibular continuity with sufficient bone for implant placement. The χ(2) test was used for statistical analysis of the categorical data and P values less than .05 were considered statistically significant.
  
  
  RESULTS
  Twenty patients with benign mandibular tumors were treated with transoral resection and immediate reconstruction with nonvascularized bone grafts. The mean age was 28.3 years (range, 9 to 63 yr) and 55% (11 of 20) were men. The most common lesion type was ameloblastoma (13 of 20) and all patients underwent reconstruction with autogenous anterior iliac crest bone grafting. Ninety percent of patients (18 of 20) had successful reconstruction. Ten patients underwent successful implant placement and restoration.
  
  
  CONCLUSIONS
  Using careful patient selection, treatment of benign pathology with transoral resection and immediate reconstruction with a nonvascularized bone graft from the anterior iliac crest can be successful. In addition, the total treatment time from implant restoration to return to preoperative function is minimized. Therefore, this method of treatment is a viable treatment option and an alternative to delayed reconstruction or reconstruction with vascularized bone flaps.
authors: Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL. Electronic address: tschlieve@gmail.com.
authors: Thomas
authors: T
authors: Schlieve
authors: Chief Resident, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL.
authors: William
authors: W
authors: Hull
authors: Professor and Head, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL.
authors: Michael
authors: M
authors: Miloro
authors: Associate Clinical Professor and Director of Research, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL.
authors: Antonia
authors: A
authors: Kolokythas
mesh_terms: D000293:Adolescent; D000328:Adult; D000564:Ameloblastoma / Q000601:surgery; D064592:Autografts / Q000637:transplantation*; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D015331:Cohort Studies; D017076:Computer-Aided Design; D003758:Dental Implantation, Endosseous / Q000379:methods; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D008953:Models, Anatomic; D010347:Patient Care Planning; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult