title: Costal Grafting in Mandibular Reconstruction.
abstract: BACKGROUND
  Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery, and free fibular flap is the gold standard for this indication. However, there are alternatives; nonvascular bone grafting is one of them, and we present the costal grafting for mandibular reconstruction, a classic technique that is reliable, efficient, and produced less morbidity than the technique of using composite free flaps.
  
  
  METHODS
  A 9-year retrospective review of 54 patients treated surgically for mandibular reconstruction was performed. The criterion mainly analyzed was graft survival. The surgical technique was described in detail.
  
  
  RESULTS
  A total of 54 patients with mandibular bone defect were identified. Five symphysis, 46 corpus, and 20 ramus defects were considered. These patients underwent reconstruction by costal grafting, and the engrafting was successful in 92.6% of cases. Dental rehabilitation with dental implants was realized in 70% of cases.
  
  
  CONCLUSIONS
  The approach described in this article allowed the authors to obtain good results with costal grafting for mandibular reconstruction and dental rehabilitation. Costal grafting is a good alternative for fibula free flap in specific indications. Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery. Since the 1980s, the gold standard for these defects is the use of free fibular flap.(1) In some cases, this technique is contradicted; the surgeon then has several possibilities for the use of free osteomyocutaneous flaps (iliac crest, scapula, and serrato-costal flaps).(2-8).
authors.affiliation: Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Jean-Thomas
authors.initials: JT
authors.lastname: Bachelet
authors.affiliation: Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Jerôme
authors.initials: J
authors.lastname: Bourlet
authors.affiliation: Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Joseph
authors.initials: J
authors.lastname: Château
authors.affiliation: Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Jacquemart
authors.affiliation: Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Dufour
authors.affiliation: Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Ali
authors.initials: A
authors.lastname: Mojallal
authors.affiliation: Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gleizal