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Review
. 2022 Mar-Apr;12(2):238-247.
doi: 10.1016/j.jobcr.2022.03.001. Epub 2022 Mar 16.

Reconstruction options in pediatric population with hemi or total mandibulectomy defects: A systematic review

Adity Bansal  1 , Shakil Ahmed Nagori  2 , Ashi Chug  1 , Ashutosh Dixit  1 , Rebecca Chowdhry  1 , Srinivas Gosla Reddy  3
Affiliations
Review

Reconstruction options in pediatric population with hemi or total mandibulectomy defects: A systematic review

Adity Bansal et al. J Oral Biol Craniofac Res. 2022 Mar-Apr.

Abstract

Purpose: Mandibular pathologies causing extensive defects in pediatrics is relatively rare, and sparse literature is available for the reconstructive options of the same. The main aim is to provide optimum esthetics and function.

Materials and methods: PubMed, Cochrane CENTRAL, Embase, MEDLINE and Scopus databases were searched for articles published only in English language up to May 2021, involving reconstruction of hemi or total mandibulectomy defects in patients with the age of 8 years or less, associated with benign or malignant pathology. Primary outcome variable was the success of reconstruction. Qualitative analysis was performed using a microsoft excel-sheet.

Results: Of the 2201 articles reviewed, only fourteen were selected for data extraction. 22 patients were included. Fifteen were benign, six were malignant pathologies, and one was not defined. Hemi-mandibulectomy was performed in twenty-one cases, while one underwent total mandibulectomy. Condyle was preserved in five cases, while was removed in nine. Single-stage reconstruction was done in nineteen cases, while second-stage reconstruction was done in the other three. Reconstruction was done with fibular graft in thirteen cases, while CCG was used in others with variable follow-up time. Though minor complications were observed, success was observed in all cases post reconstruction with either fibula or CCG graft, defined either by function, or growth.

Conclusion: Irrespective of the age-group, nature of pathology and size of the defect, reconstruction should be considered with either fibula or CCG in single-stage, as they are equally efficacious, with minor complications. Well-defined reconstructive paradigm should be developed for pediatric mandibular reconstruction.

Keywords: Costochondral graft; Fibula graft; Hemi-mandibulectomy; Mandibular pathology; Mandibular reconstruction; Total mandibulectomy.

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Conflict of interest statement

There is no conflict of interest to declare from any of the authors.

Figures

Fig. 1
Fig. 1
Shows the PRISMA flowchart depicting the selection process.
See this image and copyright information in PMC

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