An audit of mandibular defect reconstruction methods in a Nigerian Tertiary Hospital.

Aims and Objectives : To audit methods of mandibular defect reconstruction used in our institution. Materials and methods : A retrospective study of mandibular bone reconstruction at the University College Hospital Ibadan between January 2001 and December 2007. Relevant records were retrieved from patients' case notes and operation register. Comparative analysis of various methods of reconstruction was done by assessing treatment outcomes such as restoration of continuity and stability, graft infection, extrusion and fractures. Results: Only 65 of the 82 patients that had mandibular continuity defect during the study period had reconstruction. Ameloblastoma accounted for 67% [n=55] of pathologies that required mandibular resection. Methods of reconstruction included non vascularised iliac bone anchored with either stainless steel wire (NVIBw) [n=38] or titanium plate (NVIBp) [n=9], titanium reconstruction plate [n=4] Steinman pin [n=12], rib graft [1] and acrylic plate temporisation [n=1]. The findings showed that titanium plate and NVIBp had the least complications in terms of infection, graft extrusion, fracture and wound dehiscence. NVIBw and Steinman pin had the highest infection rates. Conclusion : We recommend the use of NVIBp and titanium reconstruction plate as they have the least complication rate. We also advocate future prospective study.