Abstract：
For less fit patients, total reconstruction of the mandible (TRM) is an elucidated alternative for severe maxillofacial defects. This study aimed to comprehensively review and analyze the existing evidence, irrespective of the underlying pathologies, to provide a consolidated overview of the current state of TRM. An electronic search was performed on PubMed, Embase, Scopus, and Google Scholar to identify studies reporting TRM without restrictions on patient age, type of pathology underlying the mandibular defect, and study type. Electronic search identified 390 studies; only 21 met the inclusion criteria, documenting 7 (33.3%) autogenous, 6 (28.6%) alloplastic, and 8 (38.1%) hybrid TRMs. All studies reported one clinical case, except for two studies that reported two patients treated with TRM. The mean age of the patients was 39.0 ± 19.4 years, and the mean follow-up was 22.3 ± 14.7 months. Osteomyelitis was the most common pathology. Bilateral condyles were preserved in only two cases. The TRM has been reported in clinical cases only and no large cohort study is available. Functional and aesthetic parameters have either not been reported or have been reported in heterogeneous formats, thus hampering comparisons of autogenous, alloplastic, and hybrid TRMs. Overall, TRM in patients presenting with severe maxillofacial defects achieved promising clinical outcomes endowed with acceptable function and aesthetics. Large cohort studies are needed to validate these results.
摘要：
对于不太健康的患者，下颌骨的完全重建（TRM）是严重颌面部缺损的一种已阐明的替代方法。本研究旨在对现有证据进行全面回顾和分析,不管潜在的病理，提供TRM当前状态的综合概述。在PubMed上进行了电子搜索，Embase,Scopus,和谷歌学者确定报告不限制患者年龄的TRM的研究，下颌骨缺损的病理类型，和研究类型。电子搜索确定了390项研究；只有21项符合纳入标准，记录7（33.3%）自生，6（28.6%）同种异体，和8（38.1％）混合TRM。所有研究报告了1例临床病例，除了两项研究报告了两名接受TRM治疗的患者。患者平均年龄为39.0±19.4岁,平均随访22.3±14.7个月。骨髓炎是最常见的病理。仅在两种情况下保留了双侧髁。TRM仅在临床病例中报道，没有大型队列研究可用。功能和美学参数要么没有报告，要么以异构格式报告，从而阻碍了自生的比较，同种异体,和混合TRM。总的来说，患有严重颌面部缺损的患者的TRM取得了有希望的临床结果，具有可接受的功能和美观性。需要大型队列研究来验证这些结果。
