Evaluation of graft stability and osteogenesis after mandibular reconstruction with preservation of inferior alveolar neurovascular bundle: A retrospective cohort study.

OBJECTIVES

The utility of the inferior alveolar neurovascular bundle for bone remodeling after mandible reconstruction is still unclear. The aim of this study is to assess the impact of inferior alveolar neurovascular bundle preservation on mandibular reconstruction and maintenance.

METHODS

Patients who underwent pathological mandible resection of benign mandibular lesions and reconstruction with an autogenous bone graft between 2011 and 2021 were included. They were divided into two groups based on whether the inferior alveolar neurovascular bundle was preserved. Patient-related data were obtained from the electronic health records, and radiological images was collected immediately, 6, 12-24 months after surgery, and more than 24 months thereafter. The primary outcomes included changes in bone mass and quality. The secondary outcomes included the assessment of mouth opening, mandibular function and sensory function. SPSS software was used to analyze significant differences.

RESULTS

A total of 18 patients (aged 15-61 years) were included, with 9 retaining inferior alveolar neurovascular bundles and 9 not. During the follow-up period, the bone mass and bone quality in the preserved group decreased less, especially within 6 months after surgery. Linear regression models showed that among the various influencing factors, in addition to the preservation of neurovascular bundles, bone mass and quality were also related to patient age, sex and the use of non or pedicled bone grafts.

CONCLUSIONS

These results demonstrate that preservation of the inferior alveolar neurovascular bundle can significantly improve the stability of the grafts' mass and quality.

CLINICAL SIGNIFICANCE: The results of this study indicate that preserving the inferior alveolar neurovascular bundle during mandibular reconstruction can reduce early graft resorption and enhance long-term graft stability, offering improved functional outcomes.