Part I. Reconstruction after total mandibulectomy with free cranial and microvascular iliac crest grafts as preparation for implants.

A young Ecuadorian girl underwent a total mandibulectomy due to infected fibrous dysplasia. In the subsequent 16 years, she was unable to speak intelligibly or masticate, surviving on liquids alone. After referral to the United States, the patient underwent six major surgical procedures that reconstructed her mandible from cranial and microvascular iliac crest grafts. The reconstruction improved her appearance and prepared her for insertion of dental implants and the eventual construction of a prosthetic device. These resulted in both functional and esthetic benefits.