Effectiveness of non-vascularized autologous iliac crest bone graft in the reconstruction of primary and secondary mandibular defects

The article presents the results of mandibular bone defect reconstruction with disruption of bone continuity using non-vascularized autologous iliac crest bone grafts (NCICBG). Objective – to conduct a clinical evaluation of the effectiveness and to determine the optimal surgical approaches for the use of NCICBG in patients with primary and secondary mandibular defects of various localizations and extents. A retrospective analysis was performed of the medical records of 32 patients (12 men and 20 women aged 21 to 67 years) treated in the Department of Maxillofacial Surgery at the Osh Interregional Joint Clinical Hospital from 2015 to 2018. The parameters evaluated included defect localization, etiology, morphological type and design of the bone graft (mono- or bicortical; monoblock or multiblock), surgical aspects of the procedure, as well as short-term and long-term clinical outcomes. Results. Primary defects were reconstructed in 23 patients (71.9%), and secondary defects in 6 patients (18.8%). Primary graft survival was achieved in 28 patients (87.5%), partial resorption was observed in 3 cases (9.4%), and complete graft rejection occurred in 1 case (3.1%). The mean time for bone regeneration was 4.5 ± 0.8 months. Complete restoration of masticatory function was recorded in 24 patients (75.0%), satisfactory restoration in 6 patients (18.8%), and partial restoration in 2 patients (6.2%). Conclusion. The use of NCICBG is a reliable and highly effective method for reconstructing mandibular bone defects. This approach achieved favorable functional and aesthetic outcomes in 95.7% of cases and satisfactory results in 4.3%, confirming its feasibility and high reliability in the treatment of patients with this pathology.