The iliac crest graft is considered the gold standard for reconstruction of large mandibular defects due to its ability to provide a large volume of cortico-cancellous bone, which ensures both structural support and rapid revascularization. It offers excellent contouring to recreate the mandibular shape and allows for the harvesting of a substantial amount of bone with minimal donor site morbidity. Additionally, the iliac crest graft provides a robust scaffold for osseointegration and dental implant placement in mandibular reconstruction, making it superior in functional and aesthetic outcomes compared to rib, calvarial, or fibula grafts in large defects.

Reference: Oral and Maxillofacial Surgery, Raymond J. Fonseca, 4th Edition.