Tenants of Mandibular Reconstruction in Segmental Defects

The primary tenant of all mandibular reconstruction (whether complex trauma recon-struction, treating ablative segmental defects, or resecting incompetent mandibular bone) is achieving functional maxillomandibular occlusion. While reconstruction plates and non-vascularized bone grafts have great utility in some circumstances, for signif-icant multi-unit defects and/or those with soft tissue loss, composite reconstruction using microvascular techniques provides an optimal outcome. Particularly with the trend toward single-operative stage reconstruction including osseous implantation with dental prosthetic placement, patient recovery, maintenance of function, and re-turn to the pre-lesional quality of life can be optimized. Further research into effects of early loading of mandibular reconstructions and the long-term effects on implant viability, tolerance of radiation, and long-term health care costs are ongoing and hope to provide further evidence to guide treatment teams.