TREATMENT OF NONUNION OF FRACTURES OF MANDIBLE BY FREE AUTOGENOUS BONE-GRAFTS

The indications for bone-grafting of the mandible are: nonunion of fragments of long standing; to replace lost bone due to gunshot wounds; carcinoma; infection, cysts, etc., provided enough of the ascending ramus is in situ or to protrude the mandible when the mental process is deficient. The preliminary steps may be thus summarized: The patient is examined to ascertain that all infection has been cleared up for at least five months, and that there are no teeth adjacent to the ends of the fragments. The roots of the teeth are always a menace to the graft, and, unless they are removed, sufficient bulk of the graft cannot be inserted. If it is found necessary to remove any teeth in this area, the operation should be deferred for two months. Of course, there are exceptions to this rule, one being when only one tooth remains in the posterior fragment; but in