Prognosis of the Mandibular Reconstructions Using AO-Reconstruction Plates

Forty one cases(37 patients) of mandibular reconstruction using AO-plates were reviewed. The patients aged from 27 to 83 years o1d(52.3±18.1 years) were followed for 5 to 42 months (mean 12.7±8.3 months). Cases were grouped by the location of reconstruction; Anterior mandible crossing midline as Group A(12 cases), body segment of the mandible as Group B(l6 cases). condyle & ramus of the mandible as Group C(13 cases). The incidence of revision as a measure of outcome was calculated by actuarial methods accounting for loss or death.

Revision or plate removal occurred in 22.2% (9 of 41 cases) with an incidence of 52.2% (6 of 12 cases) in Group A, 12.5%(2 of 16 cases) in Group B, and 7.7%(l of 13 cases) in Group C. Combined use of AO-plate and bone graft had a revision rate of 33.3% (4 of 12 cases), while the reconstructions with plate only had a rate of 17.2%(5 of 29 cases). The difference between the immediate reconstructions(19.2% ; 5 of 26 cases) and delayed reconstructions(26.7% ; 4 of 15 cases) was not significent. but the delayed reconstruction of the anterior mandible resulted in highest failure rate of 57.1% (4 of 7 cases).

The revision incidence was significantly high when the area had been radiated. 33.3% of 24 radiated cases, while 5.7% of not radiated cases required revision. Particularly, the radiated Group A resulted in remarkable higher failure rate(63.2% of 10 cases) Mouth opening over 30min was obtained in 92.3% of Group C, in 63.8% of Group B. but only in 52.2% of Group A. Joint pain which was mild and tolerable was noted in 3 of 13 Group C patients.