Mandibular Reconstruction Using Custom-Made Titanium Mesh Tray and Autogenous Bone Graft- A Case Report

The available options for reconstruction of bony defects of the mandible include free graft, non-vascularized graft, pedicle flap, distraction osteogenesis, reconstruction plate, Titanium-made mesh (Ti-mesh) and allografts. Ti-mesh is a reconstruction method that has the advantage of forming the mandibular shape, which is created, based on prototype and lead to improvement in appearance, activity, swallowing, chewing, speech, mood and mental health. The feasibility of this method is remarkable. Case Presentation: A 35-year-old female whom underwent left mandibular resection due to aggressive central giant-cell granuloma and failure of reconstruction using plate and autogenous bone graft, presented as a candidate for reconstruction with a custom-made Ti-mesh tray using prototype and autologous bone from ilium with allograft, because of gradually developed limitation in the mouth opening, alteration of facial contour, asymmetry and deviation. Conclusions: Using 3D CT scan to produce a prototype and reconstruct the mandible with a custom-made Ti-mesh tray was useful. Patient was followed up for 14 months. Mandibular deviation was largely corrected. There was no complication in the donor site. No sign of extra or intra oral fistula, dehiscence or infection was detected. Ti-mesh technique has three major advantages over other methods: it can reproduce the natural configuration of the mandible, needs no special surgical experience and can be harvested from the iliac crest with no complication or failure.