Experience with 220 cases of mandibular reconstruction.

Extensive resections of the mandible are usually carried out for malignat tumours or non-malignant tumours with a tendency to reccur, such as ameloblastomas. These hemi-resections include the ascending and horizontal ramus of the mandible. Such mutilations have serious functional and aesthetic consequences. In order to avoid these drawbacks we use two sorts of implants. The first are made from metallic and plastic materials. They are used when patients are too weak to support a bone graft, when there is insufficient soft tissue coverage, or when a recurrence of the tumour is feared. In order to be well tolerated they must be made of materials which are fully accepted by the tissues. For the plastic part we use methyl-methacrylate and, for the metal part, "durallium". The second type is used to maintain a bone graft in good position. It is completely metallic. The pattern is made in wax and reproduced in durallium. They are made and adjusted in the same way as plastic implants. The results are analysed separately covering two periods. In the first (1955-1967), the failures have been relatively large (25%). During the second period (1967-1974), a better choice of operative indications and a more precise technique gave better results (failure: 13%).