Salvage to Success: Overcoming Reconstructive Challenges in Dental Rehabilitation After Segmental Mandibulectomy

Ameloblastoma is the most common clinically significant odontogenic tumor. Although benign, it can be locally aggressive. A patient was referred to our academic institution for treatment of a diagnosed left mandibular follicular ameloblastoma. The patient was counseled on the risks and benefits of resection and reconstruction with either an anterior iliac crest bone graft (AICBG) or a free fibula flap (FFF) and elected to proceed with AICBG reconstruction. Following an initial phase of dental extractions and soft tissue healing, the patient underwent segmental resection and left mandibular reconstruction with a left AICBG. The patient initially did well but later developed an intraoral communication that resulted in infection and partial loss of the graft. After surgical debridement and a period of healing, the mandible was reconstructed using a right AICBG. The patient ultimately healed well and was rehabilitated with four conventional endosteal implants placed into the grafted mandible.