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Mandibular Reconstructive Surgery

Complex reconstruction of mandibular continuity and form following oncologic resection, trauma, osteoradionecrosis, or congenital defects using vascularized free flaps (fibula, iliac crest, scapula), virtual surgical planning, and dental implant rehabilitation for restored function and aesthetics.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Mandibular Reconstructive Surgery?

Mandibular reconstructive surgery addresses defects in the lower jaw resulting from oncologic resection (squamous cell carcinoma, osteosarcoma, ameloblastoma), trauma (gunshot wounds, complex fractures), osteoradionecrosis (post-radiation), bisphosphonate-related osteonecrosis (MRONJ), and congenital defects (Treacher Collins, hemifacial microsomia). The mandible's role in mastication, speech, swallowing, airway support, and facial aesthetics demands precise reconstruction.

Vascularized free flaps revolutionized mandibular reconstruction. The fibula osteocutaneous free flap (Hidalgo, 1989) is the workhorse: provides up to 25cm of bicortical bone, allows multiple osteotomies, includes skin paddle for intraoral lining, and provides adequate height for dental implants. Alternative flaps include deep circumflex iliac artery (DCIA) flap, scapular tip free flap, and radial forearm osteocutaneous flap for shorter defects.

Modern advances include virtual surgical planning (VSP) with 3D-printed cutting guides for both donor and recipient sites, patient-specific reconstruction plates (Synthes ProPlan, Materialise), immediate dental implant placement (jaw-in-a-day), and digital occlusal restoration. Computer-assisted planning improves surgical accuracy, reduces operative time, and enables predictable functional and aesthetic outcomes.

Symptoms

Pain and inability to chew following mandibular trauma
Oral mass with bone destruction (oncologic)
Exposed bone in the mouth (osteoradionecrosis, MRONJ)
Asymmetric jaw appearance
Limited mouth opening (trismus)
Difficulty with speech, swallowing, or airway
Drooling or oral incompetence

Risk Factors

Oral cancer (squamous cell carcinoma, sarcoma)
Prior head and neck radiotherapy
Bisphosphonate or denosumab therapy
Severe maxillofacial trauma
Tobacco and alcohol abuse
Poorly controlled diabetes (osteoradionecrosis risk)
Congenital craniofacial syndromes

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent oral mass or non-healing ulcer
  • Mandibular swelling or pain
  • Inability to fully open mouth or chew
  • Visible bone in the mouth (post-radiation, post-extraction)
  • Severe facial trauma with jaw involvement
  • Recurrent oral infection or drainage
  • Asymmetric jaw growth in child

Treatment Methods

01
Fibula osteocutaneous free flap reconstruction (gold standard)
02
DCIA, scapular tip, or radial forearm osteocutaneous flap alternatives
03
Virtual surgical planning with patient-specific cutting guides
04
Patient-specific 3D-printed titanium reconstruction plate
05
Immediate dental implant placement (jaw-in-a-day protocol)
06
Hyperbaric oxygen therapy for osteoradionecrosis
07
Multidisciplinary team (head and neck, plastic, oral surgery, prosthodontics)

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.