Clinical Paper
Reconstructive Surgery
Immediate reconstruction of the mandible after resection for aggressive odontogenic tumours: a cohort study

https://doi.org/10.1016/j.ijom.2012.07.010Get rights and content

Abstract

The results are reported of a clinical follow-up study on 32 selected but consecutive patients with mandibular ameloblastoma. They were all treated by a segmental resection and reconstructed, using two 2.3 mm reconstruction plates and an autogenous particulate bone graft, taken from the anterior iliac crest, and platelet rich plasma. Follow-up ranged from 12 to 39 months, with an average of 27.9 months. Undisturbed healing occurred in 29 patients, while three had postoperative infections, but in only one case did that result in failure of the graft. The patients’ appreciation was measured using an adapted quality of life questionnaire. The results were compared with a similar group who did not undergo reconstruction. The eating of solid food, appearance and speech were considerably better in the reconstructed group. The conclusion is that this means of reconstruction is appropriate for patients with benign but aggressive odontogenic tumours of the mandible, particularly in developing countries, since the expenses seem to be affordable.

Section snippets

Materials and methods

From 2003 until 2010, 32 selected but consecutive patients underwent immediate reconstruction of the mandible after ablative surgery for an ameloblastoma. Locations of the ameloblastoma lesions in the mandible of patients who underwent reconstruction are shown in Fig. 1. Five of these patients have been reported on in the preliminary study on 11 patients from the same institution.1 The first six patients of that early series of 11 cases were left out in the current study, since problems had

Results

32 patients (11 males and 21 females) with an average age of 27.7 years were included in this study. The follow-up ranged from 6 months to 7 years; the average was 27.9 months. The particulars of the patients are presented in Table 1. Healing was uneventful in all patients, except three. In one patient a serious infection occurred within 10 days which necessitated continuation of antimicrobial treatment and drainage and rinsing via the submandibular wound. It subsided after protracted use of

Discussion

The follow-up in this group of patients varies (Table 1), which is partly explained by the fact that patients have to travel for several days at considerable cost to reach the maxillofacial unit. The majority of the Tanzanian population has no medical insurance and has to pay the expenses themselves. The results of this study, point towards the viability of the method used, in that adequate reconstructions were achieved leading to a high degree of satisfaction as borne out by the QOL scores of

Funding

Plates and screws were provided by KLS-Martin.

Competing interests

None.

Ethical approval

Not required.

Acknowledgement

The authors would like to express their gratitude to KLS-Martin, Tuttlingen, Germany, for their kind support through donations of titanium plates and screws for all the patients in this study.

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