Mandibular Reconstruction Following Cyst Recurrence

Dear Colleagues,

This clinical case highlights a complex mandibular reconstruction in a 33-year-old male patient with a long-standing cystic condition. He was a smoker (half a pack per day), although he had no other relevant medical history.

Cyst Recurrence and Surgical History

In 2007, the patient was diagnosed with a cyst in the right mandibular body. Teeth 43 to 46 were extracted at that time. The surgical team performed cystectomy and apicoectomy procedures on the affected roots.

Unfortunately, one year later, the site reopened. The patient presented with persistent drainage and root exposure. Bone loss continued, and another intervention took place in 2011. However, the condition still progressed despite that second attempt.

Stabilization and Preparation for Reconstruction

When he arrived at our clinic in 2023, we observed persistent inflammation and exposure of teeth 44 to 46. We extracted these teeth and thoroughly cleaned the cystic cavity. Rather than reconstruct immediately, we allowed six weeks for soft tissue healing.

This delay proved critical. The tissue stabilized, drainage ceased, and the pathology showed no signs of recurrence.

Surgical Technique for Mandibular Reconstruction

Once healing was confirmed, we proceeded with mandibular reconstruction. We harvested a cortico-cancellous autograft from the ipsilateral retromolar area. Using a conventional approach, we adapted the graft to the mandibular defect and secured it for integration.

The goal was to restore volume, function, and prepare the site for future implant placement.

📎 PubMed: Bone grafting in mandibular defects
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