Avaliação das reconstruções ósseas realizadas pela equipe de Cirurgia e Traumatologia Bucomaxilofacial da Universidade Federal de Uberlândia no período de 2010 a 2021

Abstract

Introduction: Mandibular bone defects often impact the patient's quality of life by altering speech, chewing, airway and facial aesthetics. Considering the functional and anatomical complexity of the mandible, its reconstruction is important for the quality of life of patients. For this reason, reconstruction options with autogenous grafts are studied, seeking the one that best restores facial function and aesthetics. Objective: To evaluate the success rate of mandibular reconstructions performed with iliac crest grafts, associated or not with hyperbaric oxygen therapy (HBO), from 2010 to 2021 by the Oral and Maxillofacial Surgery and Traumatology (CTBMF) team in patients treated at the Dental Hospital of the Federal University of Uberlândia. Methodology: (CAAE: 64784222.5.0000.5152) It consisted of a retrospective descriptive study, through the analysis of all medical records from the Dental Hospital and the Hospital de Clínicas, of patients reconstructed by the Oral and Maxillofacial Surgery and Traumatology team from 2010 to 2021. Data collection took place by filling out a form developed for the study, based on information contained in the medical records of the reconstructed patients, with access approved by the Dental Hospital team and access authorized by the Hospital de Clínicas. The patient's social data, past medical history, bone defect data, reconstruction data, among other outcomes were collected. Results: 115 medical records were evaluated and 29 were included. It was found that bone defects were more prevalent in males (55.17%), in leucoderma patients (58.62%), with a mean age of 41 years. 19 defects were due to benign tumors, 7 from gunshot wounds, 1 from osteomyelitis, 1 from osteosarcoma and 1 from a motorcycle accident, 19 of which were partial and 10 marginal. The grafts were usually in block and associated with particulates (75.86%) and the main fixation system was 2.4 mm (72.41%). In addition, 21 patients received hyperbaric oxygen therapy and of these 80.95% were successful, however 19.04% of these patients evolved with graft loss, while of those who did not receive hyperbaric oxygen therapy none evolved with graft loss, but 37.5% evolved with postoperative complications. Graft sizes ranged from 2 cm to 13 cm, with the average size for patients undergoing hyperbaric oxygen therapy being 8.19 cm and for those who did not undergo hyperbaric oxygen therapy being 3.87 cm. Conclusion: Most reconstructions were successful, although it is important to consider that large grafts have a greater potential for failure because they are free grafts.