Recent Advances in Mandibular Reconstruction
In this chapter by Dr. Edward Chang, mention is made of all the current alternatives at our disposal for mandibular reconstruction, including the Fibula, Iliac Crest and Scapula. For several reasons, important amongst which is the possibility of a simultaneous two-team approach, the Fibula remains the most favored.The use of CAD-CAM technology for planning enables us to work along accurate cutting guides with placement of implants up front even before osteotomies are made. The only limitation of such technologies is the prohibitive cost and the relative inflexibility of excision limits.
For benign cases, trauma, and in patients where excision margins can be clearly defined prior to surgery, it appears that primary implants are the way to go.
With increasing reliability of vascularized bony transfer, complete dental rehabilitation is the next logical step towards complete restoration, and is highlighted