Background: Mandibular reconstruction has changed significantly over the years and continues to evolve with the introduction of newer technologies and techniques. The purpose of this study was to determine the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstructions.

Methods: The charts of patients who underwent mandibular reconstruction between 1998 and 2012 at the Maxillofacial Surgery of Parma were reviewed.

Results: The success rate found in this study was around 98%. Only 5.5% of the cases showed poor results regarding facial contours and mouth opening. All other patients were satisfied with their cosmesis and mouth opening at the recipient sites was in the normal range during last follow-up visits.

Conclusion: Fibular flap was the flap of choice in total/subtotal mandibulectomy, but it does not appear preferable in hemimandibulectomy and/or in cases of segmental mandibulectomy, if compared with the iliac crest whose main advantages are the large amount of bone provided, its height, and the possibility of including the internal oblique muscle. The scapular osteocutaneous flap is an optimal method for mandibular defect reconstruction and considering the very low rate of donor site morbidity is an excellent choice for patients who require a fast postoperative rehabilitation.