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Objectives: Reconstruction of large mandiblular defects following ablative oncologic surgery could be done by using vascularized bone transfer or, more often, primarily with simultaneous or delayed bone grafting, using load bearing reconstruction plates. Bending of these reconstruction plates is typically directed along the outer contour of the original mandible. Simultaneously or in a second operation vascularized or non-vascularized bone is fixed to the reconstruction plate. However, the prosthodontic-driven backward planning to ease bony reconstruction of the mandible in terms of dental rehabilitation using implant-retained overdentures might be an eligible solution. The purpose of this work was to develop, establish and clinically evaluate a novel 3D planning procedure for mandibular reconstruction., Materials and Methods: Three patients with tumors involving the mandible, which included squamous cell carcinoma in the floor of the mouth and keratocystic odontogenic tumor, were treated surgically by hemimandibulectomy., Results: In primary alloplastic mandible reconstruction, shape and size of the reconstruction plate could be predefined and prebent prior to surgery., Clinical Relevance: This study provides modern treatment strategies for mandibular reconstruction.

Purpose: The aim of the present retrospective study was to assess the suitability of segmental mandibular sandwich osteotomy combined with an interpositional autograft to meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible., Patients and Methods: A total of 27 consecutive patients (6 men and 21 women) were included in the present study. The amount of bone gain was calculated using digital volume tomography before surgery and 3 months after bone augmentation., Results: The postoperative course was uneventful for 18 patients. Temporary sensory disturbances were observed in 6 patients, with complete recovery after 3 to 12 weeks. Dehiscence of soft tissue closure occurred in 3 patients. The mean vertical gain was 3.41 mm (range 0.3 to 12). The mean horizontal gain was 3.08 mm (range 0.2 to 8.5). A total of 88 implants were placed in 40 surgical sites at 12 weeks after bone reconstruction., Conclusion: Segmental mandibular sandwich osteotomy is a suitable augmentation procedure in the mandible for the atrophic alveolar ridge and provides adequate height and transversal bone augmentation., (Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)