Nonvascularized and microsurgically revascularized iliac bone grafts used for mandibular reconstruction behave differently during healing. Quantitative computer tomography (QCT) was used to investigate these differences with respect to mineralization and macrostructure of the grafts after a period of adequate functional loading. It was shown that in nonvascularized grafts, reactive sclerosis occurs, as a sign of an irregularly reparative metaplastic process and mineralization. In comparison with the intact iliac crest, the bone density of the graft was markedly increased. The microsurgically revascularized grafts, however, showed retention of structural differentiation into homogeneous cancellous bone, and a smoothly demarcated cortex with essentially unchanged bone density. Possible explanations of these differences are discussed.
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