Reconstruction of Continuity Defects of the Mandible with Non-vascularized Bone Grafts. Systematic Literature Review

BACKGROUND: The use of NVBG for mandibular defects seems to be gradually giving way for more advanced reconstructive techniques but it has the advantages of shorter operating time and lesser amount of blood loss. The aim of this study was to review the available data on the success and failure rates of use of NVBG and factors associated with failure. METHOD: Studies published from 1978 to 2014 regarding the use of NVBG were searched. Most important information was graft success and failure outcomes. Information on graft success with particular focus on large defects was extracted and the quality of papers was rated. Defects > 6cm were considered long defects. RESULTS: Twenty publications were included in this review. The quality of the studies was low and there was high heterogeneity. All articles reported high graft success rates ranging from 67 to 100%. Success in defects > 6cm was considerable, the range was 72-100%. Three main factors were associated with failure; these were defect length, fixation method and infection. Infection contributed the highest complication rate which was 48.2%. CONCLUSION: NVBG seems to be appropriate for mandible reconstruction when there is vascular recipient bed and sufficient soft tissue cover and mucosal lining are achievable.