Oral and Maxillofacial Surgery

, Volume 23, Issue 2, pp 193–199 | Cite as

Reconstruction plate-related complications in mandibular continuity defects

  • Salwan Yousif Hanna BedeEmail author
  • Waleed Khaleel Ismael
  • Ehssan Ali Hashim
Original Article



The purpose of this study was to evaluate the complications associated with the use of reconstruction plates with or without non-vascularized bone graft in reconstruction of mandibular segmental defects caused by trauma and tumor resection and to analyze various factors that are associated with the development of complications.


A retrospective observational study was conducted, and the investigated variables included the age and gender of the patients, etiology of the defect, the site of the defect, the size of the defect, whether bone graft was used or not, type of plate used, and whether the reconstruction was immediate or delayed. The outcome variables were the postoperative complications and the success rate.


Fifty-one patients were enrolled in this study; the etiology of mandibular defect was trauma in 39 patients (76.5%) and resection of benign or malignant tumors in 12 patients (23.5%). The complication rate was (58.8%) and the success rate was (94.1%); the only factor that significantly increased the incidence of postoperative complications was the size of the defect.


Reconstruction plates demonstrated a high success rate despite the high complication rate. Segmental defects caused by trauma were smaller than those created after tumor resection and the only factor that increased complication rate was the size of the defect; other factors did not affect the complication rate.


Complications Mandibular continuity defects Reconstruction of mandible Reconstruction plate 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Not required.


  1. 1.
    Kademani D, Keller E (2006) Iliac crest grafting for mandibular reconstruction. Atlas Oral Maxillofacial Surg Clin N Am 14:161–170CrossRefGoogle Scholar
  2. 2.
    Wong RCW, Tideman H, Kin L, Merkx MAW (2010) Biomechanics of mandibular reconstruction: a review. Int J Oral Maxillofac Surg 39:313–319CrossRefPubMedGoogle Scholar
  3. 3.
    Fernandes R, Yetzer J (2013) Reconstruction of acquired oromandibular defects. Oral Maxillofacial Surg Clin N Am 25:241–249CrossRefGoogle Scholar
  4. 4.
    Brown JS, Barry C, Ho M, Shaw R (2016) The new classification for mandibular defects after oncological resection. Lancet Oncol 17(1):e23–e30CrossRefPubMedGoogle Scholar
  5. 5.
    Jewer DD, Boyd JB, Manktelow RT, Zuker RM, Rosen IB, Gullane PJ, Rotstein LE, Freeman JE (1989) Orofacial and mandibular reconstruction with the iliac crest free flap: a review of 60 cases and a new method of classification. Plast Reconstr Surg 84:391–403CrossRefPubMedGoogle Scholar
  6. 6.
    Chim H, Salgado CJ, Mardini S, Chen H-C (2010) Reconstruction of mandibular defects. Semin Plast Surg 24:188–197CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Simon ENM, Merkx MAW, Shubi FM, Kalyanyama BM, Stoelinga PJW (2006) Reconstruction of the mandible after ablative surgery for the treatment of aggressive, benign odontogenic tumours in Tanzania: a preliminary study. Int J Oral Maxillofac Surg 35:421–426CrossRefPubMedGoogle Scholar
  8. 8.
    Akinbami BO (2016) Reconstruction of continuity defects of the mandible with non-vascularized bone grafts. Systematic literature review. Craniomaxillofac Trauma Reconstruction 9:195–205CrossRefGoogle Scholar
  9. 9.
    Pogrel MA, Podlesh S, Anthony JP, Alexander J (1997) A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofac Surg 55:1200–1206CrossRefPubMedGoogle Scholar
  10. 10.
    Merkx MAW, Fennis JPM, Verhagen CM, Stoelinga PJW (2004) Reconstruction of the mandible using preshaped 2.3 mm titanium plates, autogenous particulate cortico-cancellous bone grafts and platelet rich plasma: a report on eight patients. Int J Oral Maxillofac Surg 33:733–739CrossRefPubMedGoogle Scholar
  11. 11.
    Goh BT, Lee S, Tidema H, Stoelinga PJW (2008) Mandibular reconstruction in adults: a review. Int J Oral Maxillofac Surg 37:597–605CrossRefPubMedGoogle Scholar
  12. 12.
    Boyd JB, Mulholland RS, Davidson J, Gullane PJ, Rotstein LE, Brown DH, Freeman JE, Irish JC (1995) The free flap and plate in oromandibular reconstruction: long-term review and indications. Plast Reconstr Surg 95:1018–1028CrossRefPubMedGoogle Scholar
  13. 13.
    Knott PD, Suh JD, Nabili V, Sercarz JA, Head C, Abemayor E, Blackwell KE (2007) Evaluation of hardware-related complications in vascularized bone grafts with locking mandibular reconstruction plate fixation. Arch Otolaryngol Head Neck Surg 133(12):1302–1306CrossRefPubMedGoogle Scholar
  14. 14.
    Kim MR, Donoff RB (1992) Critical analysis of mandibular reconstruction using AO reconstruction plates. J Oral Maxillofac Surg 50:1152–1157CrossRefPubMedGoogle Scholar
  15. 15.
    Bede SYH, Ismael WK, Al-Assaf D (2017) Characteristics of mandibular injuries caused by bullets and improvised explosive devices: a comparative study. Int J Oral Maxillofac Surg 46:1271–1275CrossRefPubMedGoogle Scholar
  16. 16.
    Seol G-J, Jeon E-G, Lee J-S, Choi S-Y, Kim J-W, Kwon T-G, Paeng J-Y (2014) Reconstruction plates used in the surgery for mandibular discontinuity defect. J Korean Assoc Oral Maxillofac Surg 40:266–271CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kämmerer PW, Klein MO, Moergel M, Gemmel M, Draenert GF (2014) Local and systemic risk factors influencing the long-term success of angular stable alloplastic reconstruction plates of the mandible. J Craniomaxillofac Surg 42:e271–e276CrossRefPubMedGoogle Scholar
  18. 18.
    Ueyama Y, Naitoh R, Yamagata A, Matsumura T (1996) Analysis of reconstruction of mandibular defects using single stainless steel A-O reconstruction plates. J Oral Maxillofac Surg 54:858–863CrossRefPubMedGoogle Scholar
  19. 19.
    Markwardt J, Pfeifer G, Eckelt U, Reitemeier B (2007) Analysis of complications after reconstruction of bone defects involving complete mandibular resection using finite element modeling. Onkologie 30:121–126PubMedGoogle Scholar
  20. 20.
    Yi Z, Jian-Gou Z, Guang-Yan Y, Ling L, Fu-Yun Z, Guo-Cheng Z (1999) Reconstruction plates to bridge mandibular defects. A clinical and experimental investigation in biomechanical aspects. Int J Oral Maxillofac Surg 28:445–450CrossRefPubMedGoogle Scholar
  21. 21.
    Kirkpatrick D, Gandhi R, Van Sickels JE (2003) Infections associated with locking reconstruction plates: a retrospective review. J Oral Maxillofac Surg 61:462–466CrossRefPubMedGoogle Scholar
  22. 22.
    Kimura A, Nagasao T, Kaneko T, Tamaki T, Miyamoto J, Nakajima T (2006) Adaquate fixation of plates for stability during mandibular reconstruction. J Craniomaxillofac Surg 34:193–200CrossRefPubMedGoogle Scholar
  23. 23.
    Shibahara T, Noma H, Furuya Y, Takaki R (2002) Fracture of mandibular reconstruction plates used after tumor resection. J Oral Maxillofac Surg 60(2):182–185CrossRefPubMedGoogle Scholar
  24. 24.
    Spencer KR, Sizeland A, Taylor GL, Wiesenfeld D (1999) The use of titanium mandibular reconstruction plates in patients with oral cancer. Int J Oral Maxillofac Surg 28:288–290CrossRefPubMedGoogle Scholar
  25. 25.
    Klotch DW, Gal TJ, Gal RL (1999) Assessment of plate use for mandibular reconstruction: has changing technology made a difference? Otolaryngol Head Neck Surg 121(4):388–392CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial Surgery, College of DentistryUniversity of BaghdadBaghdadIraq
  2. 2.Oral and Maxillofacial Surgery UnitAlyarmook Teaching HospitalBaghdadIraq

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