Currently, maxillofacial surgery has a wide range of methods for rehabilitation of patients with mandibular defects. Replenishment of local mandibular defects implies creation of optimal conditions for subsequent oral-maxillofacial rehabilitation of patients with minimal donor damage. Development of new methods for plastic closure of local mandibular defects and searching for new donor areas are promising directions in reconstructive maxillofacial surgery.

OBJECTIVE

To increase an effectiveness of complex surgical treatment of patients with various local mandibular defects.

MATERIAL AND METHODS

Plastic replenishment of a linear local lateral mandibular defect up to 50 mm was performed in 11 patients. Subsequently, they underwent various methods of dental and maxillofacial rehabilitation including orthopedic structures based on dental implants. 3D CT modeling was applied to place native fragments of mandible in correct anatomic position, to determine dimension and topography of defect and to select donor site from parietal bone with necessary curvature and design of cortical autografts. Postoperative results were estimated in 3 and 6 months after surgery. Then, dental implants were installed and prosthetic construction was created 3 months later.

RESULTS

In 10 patients, integrity of the mandible was preserved in 3 (orthopantomography) and 6 (CT) months after surgery. One patient had local inflammatory process that was stopped and did not affect postoperative result.

CONCLUSION

Split thickness parietal bone grafts for closure of local mandibular defect and further dental implantation are optimal approaches for these patients.