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Infected mobile mandibular bone plate placed elsewhere was removed and successfully reconstructed using costochondral rib graft

10/4/2017

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A 36 year old woman reported to our hospital with the complaint of missing teeth along with the bone in the front region of lower jaw. She added that the anterior mandibular segment was removed due to ameloblastoma and reconstruction plate was fixed few years back elsewhere and she was not able to chew foods and speak well due to missing teeth along with the bone. She wanted permanent reconstruction of her mandible and fixed teeth.
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After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S. M. Balaji planned to reconstruct her mandibular defect using costochondral rib graft following which dental implants will be fixed into the newly formed bone. Intraorally, the infected mobile mandibular reconstruction plate and screws placed elsewhere were removed and reconstructed using costochondral rib graft along with the titanium mandibular reconstruction plate. Incision was closed in layers. Patient feels very happy to have complete reconstruction in a single surgery. Following new bone formation fixed dental implant replacement will be done for her missing teeth.  
Digital OPG showing huge bony defect in entire anterior region of mandible with missing anterior teeth
3DCT view showing secondary bone defect in mandibular symphysis region
Intraoral view showing missing teeth with bone and medially displaced mandibular segments
Medial displacement of mandibular segments due to missing bone in the midline of mandible
Costochondral rib graft obtained to reconstruct the mandibular defect
Rib graft obtained for mandibular reconstruction
Layerwise suturing of the chest region
Surgical exposure of previous infected mobile mandibular reconstruction plate
Infected mobile mandibular reconstruction plate removed in toto
Titanium mandibular reconstruction plate fixed to the adjacent mandibular segments
Costochondral rib graft approximated with the reconstruction plate for mandibular reconstruction
Immediately after suturing
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