Materials and methods:we conducted a retrospective analysis of cases of mandibular continuity defects that were reconstructed with non vascularised iliac crest bone at the University College Hospital Ibadan over a 51/2year period(jan2001-june2006).Records were obtained from patients' case notes and operatory register.Pre operative diagnosis, post operative follow up records including investigations, diagnosis of graft infection and subsequent treatment modalities were extracted from the available records.
Results:Seventy one patients had mandibular continuity defects within the study period. Only 31 patients had mandibular defect reconstruction with non vascularised iliac crest block bone and these included 21 cases of ameloblastoma, 3 primodial cysts, 3 dentigerous cysts, 2 gunshots and 2 mandibular fractures with continuity defects. Twelve of d patients were females while nineteen were males, the mean age of the patients is 24.6years. Ten(32.2%) patients developed persistent graft infection during the post operative period. 60% of the infected grafts revealed mixed microbial isolates containing Klebsiela spp, Pseudomonas aeurogenosa and E coli. Six (60%) of the infected grafts were excised as a result of unabated infection while 4(40%) were treated by exploration and drainage of pus.
Conclusion:The use of free vascularised bone graft and bridging mandibular plates have gained much ground recently in the management of mandibular continuity defect. Non vascularised iliac bone also provides an affordable choice for mandibular reconstruction in developing countries. However, the high incidence of infection noted in our study can be overcome with careful tissue handling and good oral hygiene motivation which should include pre operative scaling and polishing.