Secondary lengthening of the reconstructed mandible using a gradual distractiontechnique—two case reports

We have performed mandibular lengthening to restore oral function in 2 case after tumour resection.Both case had already undergone a vascularised fibular graft for mandibular reconstruction and had severe constracture and absence of an alveolar ridge for dentures. Gradual distraction was applied after corticotomy of the fibular bone at 0.9 mm per day. After completion of bone lengthening of 20–30 mm, both patients underwent a split thickness skin graft to obtain a good alveolar ridge for dentures and implants. Osteointegrated implants have since been applied in one of these cases, and other patient has been able to eat a normal diet using dentures. Gradual distraction is applicable for vascularised bone grafts and useful for restoration of the alveolar ridge to accommodate dentures in cases with severe contracture of the oral space after tumour ablation.