Randomized control trial of non-vascularized fibular and iliac crest graft for mandibular reconstruction

BackgroundMandibular reconstruction of segmental defects caused by trauma or tumor excision is a challenge despite numerous advances in surgical and fixation techniques. Bone grafts from fibula or iliac crest are most frequently used to reconstruct mandible.MethodsA prospective randomized study was performed in 20 patients with benign mandibular pathology, to compare non-vascularized fibular and iliac crest bone graft for graft success, improvement in esthetics and function, and any associated donor site complications.ResultsNo significant difference in graft success, esthetics, function, or donor site complication were found between the two groups. Function improvement was significantly higher in fibula group as compared to iliac crest. An interesting finding of positive association between length of defect and complication was seen irrespective of the graft used, implying that patients with larger defects had higher complication rates.ConclusionNon-vascularized fibular bone graft is as better as iliac crest for reconstruction of mandibular defects of optimal length.