SUCCESSFUL ANTERIOR ILIAC CREST BONE GRAFTING FOR MANDIBULAR DEFECT RECONSTRUCTION: EVALUATION AND OUTCOMES USING NVBG TECHNIQUE IN YEMEN

Lutf Mohammed Al-Rahbi; Abdulrahman Ali Abdulrahman Abdulsattar; Hassan Abdulwahab Al-Shamahy; Ahmed Abdulah Al-Ashwal

doi:10.22270/ujpr.v10i6.1458

Lutf Mohammed Al-Rahbi Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Sana’a University, Republic of Yemen. Yemen Medical Specialist Council, Ministry of Health and population, Yemen.
Abdulrahman Ali Abdulrahman Abdulsattar Yemen Medical Specialist Council, Ministry of Health and population, Yemen.
Hassan Abdulwahab Al-Shamahy Department of Basic Sciences, Faculty of Dentistry, Sana’a University, Republic of Yemen. Medical Microbiology and Clinical Immunology Department, Faculty of Medicine and Health Sciences, Sana’a University.
Ahmed Abdulah Al-Ashwal Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Sana’a University, Republic of Yemen. Yemen Medical Specialist Council, Ministry of Health and population, Yemen.

10.22270/ujpr.v10i6.1458

Keywords:

Anterior iliac crest, bone grafting, reconstructing mandibular defects, Yemen

Abstract

Background and Aims: Bone grafting from the anterior iliac crest is a common and effective method for reconstructing large mandibular defects, as it provides a good source of cortical and cancellous bone. The anterior iliac crest is a preferred donor site due to the large amount of bone available, its anatomical similarity to the mandible, and the possibility of performing a two-team procedure, which reduces overall surgical time. However, potential complications at the donor site include pain, sensory changes, and gait disturbance. This study aimed to evaluate data from 11 patients undergoing mandibular reconstruction using the NVBG technique at our center.

Materials and Methods: There were eleven individuals with mandibular reconstruction. Continuity defect and non-continuity defect patients were separated. Factors influencing success were examined, including immediate repair, smoking habit, medical comorbidities, defect site and size, surgical technique, and use of maxilla-mandibular fixation. Success was defined as the preservation of the bone graft for non-continuity defects (NCD) and the continuity and stability of the bone for continuity defects (CD), as well as the absence of infection at the most recent clinical and radiographic assessment. There were two categories for complications: minor and significant.

Results: Reconstruction was successful in 12 procedures out of 13 procedures. Analyses showed that the size of the defect was strongly associated with failure. Three patients experienced major complications such as bacterial infection and non-union, and eight experienced minor complications.

Conclusion: Non-vascularized iliac crest bone grafts achieve high success in restoring continuity of the mandible in fractures caused by gunshots, bomb explosions and should be considered the first choice for defects less than 6 cm in diameter. No defects larger than 5.5 cm were recorded in current study.