Immediate Mandibular Reconstruction Using a Cellular Bone Allograft Following Tumor Resection in a Pediatric Patient

Abstract

Reconstruction of large segmental mandibular defects presents a challenge for oral and maxillofacial surgeons, particularly in the skeletally immature pediatric patient. Autogenous bone graft is historically preferred; however, harvest of autograft requires a second surgical site, risking donor-site complications as well as the potential for long-term complications in the growing child. Here, we present the first known report of a pediatric patient who underwent immediate mandibular reconstruction of a 6.5-cm long segmental defect using a cellular bone allograft (VF-CBA) combined with custom-fabricated guides and plates following tumor resection. The use of VF-CBA, along with the custom guides and plates, eliminated the need for autograft harvest in a child, enabled an entirely intraoral approach, avoiding the creation of a cutaneous scar, and reduced the total operative time, resulting in a fast recovery and improved patient satisfaction. By 7 months postoperative, the patient’s mandible was fully healed with solid osseous consolidation. These results support VF-CBA combined with custom intraoral guides and plates as an effective treatment option for reconstruction of large segmental mandibular defects in a pediatric patient.