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Reconstruction of Major Anterior Defects of the Mandible

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Craniomaxillofacial Reconstructive and Corrective Bone Surgery

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Abstract

Central defects of the mandible can be exceedingly challenging to reconstruct and commonly result from tumor extirpation or high-energy trauma. Based on our center’s experience treating complex secondary facial deformities, we believe noncritical and non-composite defects of the anterior mandible can be reconstructed with conventional bone grafts. We also advocate early reconstruction of critical-sized composite central defects of the mandible with microvascular free flaps to achieve superior functional and aesthetic outcomes.

In cases secondary to malignancy, immediate microvascular free flap reconstruction provides the best outcomes. This review provides an overview of the various microvascular options available to reconstruct these challenging defects. Options include the free fibula osteoseptocutaneous flap, free iliac osteocutaneous flap, free radial osteocutaneous flap, and free scapular osteocutaneous flap. Among these options, the free fibula and free iliac are ideal since they provide sufficient bone stock for endosseous implants and soft tissue for resurfacing of any oral defects.

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Authors and Affiliations

  1. Department of Plastic Surgery, NYU Langone Hospital, New York, NY, USA

    Edwardo Rodriguez

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  1. Edwardo Rodriguez
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Correspondence to Edwardo Rodriguez .

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Editors and Affiliations

  1. Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine and New York Presbyterian Hospital, New York, NY, USA

    Alex M. Greenberg

  2. Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery, Center for Dental Medicine, Medical Center – University of Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Rainer Schmelzeisen

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Rodriguez, E. (2019). Reconstruction of Major Anterior Defects of the Mandible. In: Greenberg, A., Schmelzeisen, R. (eds) Craniomaxillofacial Reconstructive and Corrective Bone Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1529-3_31

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  • DOI: https://doi.org/10.1007/978-1-4939-1529-3_31

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1528-6

  • Online ISBN: 978-1-4939-1529-3

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