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Autogenous, alloplastic, or hybrid for total mandibular reconstruction; is here an optimal path?

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Abstract

For less fit patients, total reconstruction of the mandible (TRM) is an elucidated alternative for severe maxillofacial defects. This study aimed to comprehensively review and analyze the existing evidence, irrespective of the underlying pathologies, to provide a consolidated overview of the current state of TRM. An electronic search was performed on PubMed, Embase, Scopus, and Google Scholar to identify studies reporting TRM without restrictions on patient age, type of pathology underlying the mandibular defect, and study type. Electronic search identified 390 studies; only 21 met the inclusion criteria, documenting 7 (33.3%) autogenous, 6 (28.6%) alloplastic, and 8 (38.1%) hybrid TRMs. All studies reported one clinical case, except for two studies that reported two patients treated with TRM. The mean age of the patients was 39.0 ± 19.4 years, and the mean follow-up was 22.3 ± 14.7 months. Osteomyelitis was the most common pathology. Bilateral condyles were preserved in only two cases. The TRM has been reported in clinical cases only and no large cohort study is available. Functional and aesthetic parameters have either not been reported or have been reported in heterogeneous formats, thus hampering comparisons of autogenous, alloplastic, and hybrid TRMs. Overall, TRM in patients presenting with severe maxillofacial defects achieved promising clinical outcomes endowed with acceptable function and aesthetics. Large cohort studies are needed to validate these results.

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Authors and Affiliations

  1. Oral and Maxillofacial Surgery, Hayatabad Medical Complex, Peshawar, Pakistan

    Yasir Rehman Khattak

  2. State Key Laboratory of Precision Measurement Technology and Instruments, Tianjin University, Tianjin, 300072, China

    Mirza Albash Baig

  3. International School for Optoelectronic Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China

    Syed Zaheer Ud Din

  4. Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan

    Iftikhar Ahmad

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  1. Yasir Rehman Khattak
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  2. Mirza Albash Baig
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  3. Syed Zaheer Ud Din
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  4. Iftikhar Ahmad
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Contributions

Conceptualization: YRK, MAB, SZD, IA. Data curation: YRK, SZD, IA. Formal analysis: YRK, MAB. Investigation: YRK, SZD. Methodology: YRK, SZD. Project administration: IA. Resources: IA. Supervision: IA. Validation: YRK, SZD. Visualization: SZD, IA. Writing – original draft: YRK, MAB, SZD, IA. Writing – review &; editing: YRK, MAB, SZD, IA.

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Correspondence to Iftikhar Ahmad.

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Khattak, Y.R., Baig, M.A., Din, S.Z.U. et al. Autogenous, alloplastic, or hybrid for total mandibular reconstruction; is here an optimal path?. Oral Maxillofac Surg (2024). https://doi.org/10.1007/s10006-024-01224-3

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