Maxillofacial Surgeon Dr. S. M. Balaji adroitly planned to remove the infected bone graft and plate and to reconstruct the lower jaw in a single surgery. He approached the surgical site extraorally through the previous scar region and removed the dislodged bone plate and sequestrum completely. Adjacent infected bone was removed with bone curette and a new NiTi bone plate was fixed to the adjacent healthy bone. To enhance the rigidity, costal graft was harvested and placed near to the bone plate with rhBMP-2 to increase the efficiency of new bone formation. Mucosal flaps were approximated in layers with very minimal scar formation.
Post operative X-ray taken after 3 months revealed good amount of healthy bone formation maintaining the contour of the mandible using bone plate.