Indications, techniques and complications of the use of non vascularised bone graft harvest for reconstruction in maxillofacial region - Our experience

Abstract

Background: Continuity defects of facial bones from any etiology require harvesting of sufficient amount of bone grafts from various sites. The purpose of the study was to review the indications, techniques and complications of non vascularised bone graft(NVBG) used for reconstruction in
the face.
Methods: The indications for grafting were documented; two techniques of harvesting of the iliac bone and rib were described. The approaches to the bones and size of autogenous bone graft harvested were documented. Clinical and radiologic evaluations were done to assess graft success and failure. Patients were followed up for at least 12 months. Complications and outcome were documented.
Results: Forty (40) bone grafts were harvested for reconstruction in the maxillofacial region in 39 patients, 22 (56.4%) males and 17(43.6%) females, mean age was 24.3(±10.9 range 6-69) years. Twenty-one (53.8%) had tumors, 8 (20.5%) had trauma, 7 (17.9%) with congenital defects and 3 (7.7%) patients had fibroosseous lesions, 29 bone grafts were harvested for lower jaw reconstruction, and 11 bone grafts were harvested for  reconstruction in the upper jaw. There was failure of graft in 4 (10.3%) patients and partial resorption in 18(46.2%) patients. The overall graft success rate was 89.7%.
Conclusion: Ameloblastoma was the highest indication for surgery. Recipient site complications was found more in tumors and trauma, graft failure occurred in trauma. Altered gait was a prominent donor site complication regardless of the technique. It was more in larger grafts. Contour defect
was however related to the technique and graft dimension.