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Year : 2012  |  Volume : 15  |  Issue : 2  |  Page : 224-227

Mandibular defect reconstruction with nonvascularized iliac crest bone graft

1 Department of Oral and Maxillofacial Surgery, University Teaching Hospital, Ado-Ekiti, Nigeria
2 Department of Orthopaedic Surgery, University College Hospital, Ibadan, Nigeria
3 Department of Oral and Maxillofacial Surgery, University of Port Hacourt Teaching Hospital, Port Hacourt, Nigeria

Correspondence Address:
O S Obimakinde
Department of Oral and Maxillofacial Surgery, University Teaching Hospital, Ado-Ekiti
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1119-3077.97334

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Context: Reconstruction of mandibular defect is a challenge to the head and neck surgeon because of associated functional and esthetic problems. Our experience with the use of nonvascularized iliac crest bone graft is hereby reported. Aim: The aim was to report our experience with the use of nonvascularized iliac crest bone for mandibular defect reconstruction at University College Hospital, Ibadan. Nigeria. Settings and Design: A retrospective descriptive study was performed. Materials and Methods: Cases of mandibular reconstruction with iliac crest bone graft between January 2001 and December 2007 were included in this study. Grafts were secured with either a stainless steel wire or a titanium plate. Preoperative diagnosis, postoperative follow-up records including investigations, diagnosis of graft infection and subsequent treatment modalities were extracted from the available records. Statistical analysis used: Descriptive variables were analyzed with SPSS version 14. Results: A total of 47 patients had mandibular defect reconstruction with nonvascularized iliac crest block bone during the study period. Thirty-eight patients had graft secured with transosseous wire [NVIBw] while 9 had a titanium plate [NVIBp]. The male:female ratio was 26:21 while the mean age of the patients was 24.6±4.25 years. Ten patients (21.3%) developed persistent graft infection during the postoperative period. All cases of infection occurred in patients who had transosseous wiring and analysis showed that 60% of the infected grafts revealed mixed microbial isolates containing Klebsiela spp, Pseudomonas Aeurogenosa, and E coli. Six (60%) of the infected grafts were removed as a result of unabated infection while 4 (40%) were successfully treated by exploration and pus drainage. Conclusions: Nonvascularized iliac crest bone graft provides an affordable and less technical choice for mandibular reconstruction with minimal complications in a resource-limited economy.

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