1*Assistant Professor, Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Science-751024. Email: chitrita.mondal@kids.ac.in. ORCID ID: 0009-0007-0408-1978
2Assistant Professor, Master of Dental Surgery, Department of Dentistry, Conservative Dentistry and Endodontics, Dr. NTR University of Health Sciences, Vijayawada. Email: g3eswar@gmail.com. ORCID ID: 0009-0004-8713-3312
3Associate Professor, Department of Oral & Maxillofacial Surgery, Inderprastha Dental College and Hospital, Sahibabad, Ghaziabad, Uttar Pradesh - 201010, India. Email: sameer.gupta83@yahoo.in
4Associate Professor, Kristu Jayanti Institute of Management, Kristu Jayanti University, K Narayanapura, Bangalore-77. Email: sarada889@yahoo.in. ORCID ID: 0000-0002-3203-7065
5Assistant Professor, Oral & Maxillofacial Surgery, Department of Dentistry, Government Medical College, Maharashtra University of Health Sciences, Nashik, Washim-444505, India. Email: avinashsonune01@gmail.com. ORCID ID: 0009-0008-0689-3715
6Professor, Periodontology and Implantology, Periodontology and Oral Implantology, Government Dental College & Research Institute, Rajiv Gandhi University of Health Sciences, Karnataka-583101, India. Email: ismail2220333@gmail.com. ORCID ID: 0009-0001-6362-0902
Title: Use of Orthopaedic Bone Grafting Techniques in Maxillofacial Reconstructive Surgery: A Prospective Clinical Series
Background: Segmental defects of the maxillofacial skeleton resulting from trauma, tumors, or osteonecrosis demand structurally sound and biologically viable grafting techniques. Iliac crest autografts and fibular free flaps (FFF) are widely employed in clinical practice, but comparative prospective data on their efficacy, integration, and functional outcomes remain limited.
Materials and Methods: This prospective clinical study included 28 patients (18 males, 10 females; mean age 42.7 ± 11.3 years) with mandibular or maxillary defects ≥3 cm. Fifteen patients received iliac crest grafts and thirteen underwent FFF reconstruction. CAD/CAM-assisted planning and custom cutting guides were used in all FFF cases. Primary outcomes included radiographic graft integration, flap viability, and donor site morbidity (Harris Hip Score, Lower Limb Functional Index). Secondary outcomes were functional recovery (Masticatory Performance Index, Intelligibility in Context Scale), aesthetic score (Visual Analog Scale), and implant readiness.
Results: Iliac crest grafts achieved 100% integration. FFF demonstrated 92.3% flap survival with no total losses. Functional and aesthetic scores favored FFF (MPI: 84.2 vs. 79.6; VAS: 8.6 vs. 8.2), with comparable speech scores (ICS ≥ 4.6). Implant rehabilitation was successful in 78.6% of cases. Donor site morbidity was minimal in both groups.
Conclusion: Both iliac crest autografts and FFF are effective options in segmental maxillofacial reconstruction. Iliac crest grafts are suitable for smaller defects, while FFF offers greater adaptability and improved functional outcomes, especially when guided by digital planning.
Keywords: Fibular free flap; Iliac crest autograft; Maxillofacial reconstruction; Segmental bone defects; CAD/CAM surgery; Bone graft integration.
How to cite this article: Mondal C, Danda OEB, Gupta S, Sarada V, Sonune A, Ismail B M. Use of Orthopaedic Bone Grafting Techniques in Maxillofacial Reconstructive Surgery: A Clinical Series. Int J Drug Deliv Technol. 2026;16(16s): 291-300. DOI: 10.25258/ijddt.16.16s.32
Source of support: Nil.
Conflict of interest: None