Large Mandibular Bone Defect Reconstruction with Calcium Phosphate Cement: A Case Report

Background: Large mandibular defects following odontogenic cyst enucleation pose reconstructive challenges because spontaneous healing is unpredictable. Calcium phosphate cements are biocompatible, osteoconductive biomaterials that may facilitate bone repair. Case Description: We describe reconstruction of an anterior mandibular defect in a 71-year-old woman following radicular cyst enucleation using injectable calcium phosphate cement. Preoperative assessment included clinical examination, panoramic radiography, cone-beam computed tomography (CBCT), and pulp sensibility testing. Imaging revealed a 27 × 35 × 6 mm defect. Cement was placed in the selected portion of the defect. Histopathological examination confirmed a radicular cyst; cyst contents underwent microbiological culture and antimicrobial susceptibility testing. Serial panoramic radiographs and final CBCT in August 2024 allowed assessment of radiopacity, trabecular architecture, and mandibular continuity. Throughout follow-up, seven adjacent teeth (FDI 43, 42, 41, 31, 33, 34, and 35) retained positive responses to cold and electric pulp testing, whereas tooth 32 remained nonresponsive and received no endodontic treatment. Postoperative recovery was uneventful, with no infection, biomaterial-related complications, or radiographic evidence of cyst recurrence. Follow-up imaging revealed diminishing radiographic contrast between the reconstructed region and surrounding bone, emergence of a trabecular-like pattern, and preserved mandibular continuity. These findings were consistent with healing and remodeling; however, imaging could not establish cement degradation or replacement by newly formed bone. Conclusions: This case demonstrates favorable clinical and radiographic outcomes following mandibular reconstruction with injectable calcium phosphate cement. Histological confirmation would be necessary to determine the extent of cement degradation and replacement by newly formed bone.