The Composite Costochondral-Iliac Crest Bone Graft: A Novel Technique for Temporomandibular Joint Reconstruction

Vascularized Treatment Options for Reconstruction of the Ascending Mandible With Introduction of the Femoral Medial Epicondyle Free Flap

“…The length of cartilage varies from 0.5 to 2 cm, although use of excess cartilage has been associated with graft overgrowth and poor skeletal stability. [14][15][16] The graft is then contoured to fit the mandible and mandibular fossa prior to fixation. From an anatomic perspective, a major benefit of the CCG is that the rib is of similar size, shape, and thickness to the mandible.…”

“…15,25 Others have commented on the poor bone quality of rib grafts, speculating that weak cortical and trabecular bone results in hardware failure and loss of vertical height over time. 14 Complications include fracture of the graft, postoperative ankylosis, and separation of the cartilage cap from the neocondyle. 28,29 Patients with a history of jaw surgery or ankylosis are predisposed to these complications, perhaps because of disrupted vasculature or scarring.…”

“…For instance, surgeons have combined the CCG with bone from the iliac crest or various free tissue transfers. 14,32 Others have used the graft in conjunction with techniques such as distraction osteogenesis. 33,34 Despite these innovations, the standard CCG remains the most common treatment modality regardless of long-term stability.…”

Mandibular reconstruction using nonvascularized autogenous bone grafting

“…The C-C graft represents perhaps the most functional type of mandibular bone reconstruction with autogenous nonvascularized bone. Aside from Fukuta's vascularized technique [6] this free graft currently remains very popular [24][25][26][27][28][29][30][31]. A variation of this with the use of combined iliac crest bone graft has been proposed by several authors [19,25].…”

“…Aside from Fukuta's vascularized technique [6] this free graft currently remains very popular [24][25][26][27][28][29][30][31]. A variation of this with the use of combined iliac crest bone graft has been proposed by several authors [19,25]. Distraction osteogenesis has emerged as a form of autogenous bone replacement for the atrophic mandible as well as for segmental defects [32][33][34] and has even been suggested as a replacement technique for the mandibular condyle [24].…”