Part II. Mandibular reconstruction: combined intra-oral and in vitro placement of osseointegrated implants into a free and vascularized bone graft.

A 28-year-old Hispanic girl underwent a complete mandibular reconstruction many years following full mandibulectomy for fibrous dysplasia. Because of infectious complications, both free cranial and microvascular iliac crest grafts were used. The patient had osseointegrated implants placed directly into the grafted mandible. Osseointegrated implants were also placed into a segment of free iliac crest bone, in vitro, and then grafted laterally onto the reconstructed mandible. Prosthetic reconstruction was then carried out to restore the patient to normal function, health, comfort, and esthetics.