Mandibular Reconstruction with Autogenous Fragment of Previous Iliac Crest Associated to Hyperbaric Oxygen Therapy: Case Report

Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modern surgery has developed more effective techniques, including no vascularized bone grafts, better alloplastic materials, vascularized loco regional grafts, soft and hard tissue compounds, bone fixation and stretching materials, and mechanisms for study models. These components have become indispensable in the surgeon's arsenal with regard to reconstructive surgery. A gold standard for mandibular bone reconstruction is the use of autogenous grafts. The objective of this study was to describe a clinical case of mandibular reconstruction with autogenous graft associated with adjuvant hyperbaric oxygen therapy. The clinical case presented shows the treatment performed for after-effects correction due to the non-consolidation of sagittal mandibular osteotomy performed for correction of standard III dentofacial deformity, resulting in a pseudoarthrosis with bite deviation and facial asymmetry. As a treatment plan, mandibular reconstruction was instituted with autogenous graft of anterior iliac crest associated with the use prototyping biomodel and hyperbaric oxygen therapy. After a control of 1 year and 6 months, no signs of recurrence were identified and the radiographic image showed excellent positioning, good volume and maintenance of the mandibular contour.