Spontaneous mandibular regeneration: another option for mandibular reconstruction in children?

Treatment for conditions of the mandible may require resection of the affected segment, and this may need reconstruction. There are case reports of spontaneous regeneration of segments of excised mandibles that resulted in reduced or no need for reconstruction, and we present four such cases. The age at presentation ranged from 6 to 12 years. In all cases the periosteum was preserved during resection. All patients showed evidence of spontaneous regeneration, both clinically and radiographically, between 3 and 5 months after resection. The planned delayed reconstruction meant that these patients either did not need any bony reconstruction, or needed less than had originally been anticipated. Such regeneration is mostly reported in children, and is thought to be the result of an intact periosteal layer. In patients having planned mandibular resections, where the periosteum is preserved, some spontaneous regeneration should be anticipated and final reconstruction delayed until this is complete.