[Functional long-term result after mandibular reconstruction with vascularized iliac bone graft. A case report].

In an eleven-year-old boy with a large sarcoma of the left mandible, a hemimandibulectomy with en bloc soft tissue resection was performed. Preoperatively a chemo-and radiotherapy was administered and after resection of the sarcoma stabilization of the remaining mandible was achieved by temporary reconstruction plate articulating in the temporomandibular fossa. Postoperative cytostatic therapy was then given and further development of the remaining mandible awaited. In the ensuing years no loco-regional or systemic manifestations of the sarcoma could be detected, therefore definitive reconstruction of the mandible was undertaken at the age of 16 years. A free osseo-musculo-cutaneous composite graft was taken from the left iliac crest and revascularisation established microsurgically. In a short time, primary healing and remodelling of the new hemimandible could be seen, hence osseointegrated dental implants were inserted in order to allow normal mastication. The process of remodelling of the reconstructed hemimandible was examined ten years later comparing X-ray findings during different periods of growth.