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Concomitant reconstruction of mandibular basal and alveolar bone with a free fibular flap

Cited 48 time in Web of Science Cited 56 time in Scopus
Authors

Lee, Jong Ho; Kim, Myung Jin; Choi, WS; Yun, Pil Young; Ahn, Kang Min; Myoung, Hoon; Hwang, Soon Jung; Seo, Byoung Moo; Choi, Jin Young; houng, Pill Houng; Kim, Soung Min

Issue Date
2004-03
Publisher
Churchill Livingstone
Citation
International Journal of Oral and Maxillofacial Surgery, Vol.33 No.2, pp.150-156
Abstract
Repair of long-span mandibular defects with a free fibular flap is now a routine procedure. However, the bone height of the neo-mandible after reconstruction with a fibular flap is about half that of the dentulous mandible. When a fibular graft is placed only at the inferior border of the mandible, the resulting vertical discrepancy between the graft segment and the occlusal plane can adversely affect implant mechanics or denture stability and retention. To overcome these problems, we developed a technique for two-strut type mandibular reconstruction. A vascularized fibular segment is used to reconstruct the inferior basal portion of the neo-mandible, while a non-vascularized residual fibular segment is used to simulate the superior alveolar portion. We used this technique in 22 patients. Graft survival, graft resorption, and the ability to place implants were assessed as compared with those after the conventional one-strut type technique. The fibular segment grafted to the alveolar region was removed in one patient with intraoral wound dehiscence and in two with postoperative infection. All vascularized fibular flaps were successful. The resorption rate was 13.6 +/- 7.2% for non-vascularized segments and 3.0 +/- 3.7% for vascularized segments. Dental implants were placed in five of our 22 patients. The crown-fixture length ratio was improved to 1:1.7, as compared with a ratio of 1: 1.21 with use of a conventional fibular flap. We conclude that our technique is very easy and safe and provides substantially improved lower-lip and cheek support and implant-prosthetic mechanics than conventional procedures for the repair of long-span mandibular defects.
ISSN
0901-5027
URI
https://hdl.handle.net/10371/200300
DOI
https://doi.org/10.1054/ijom.2003.0487
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Yun, Pil Young윤필영
(기금)부교수
  • School of Dentistry
  • Department of Dentistry
Research Area Dentistry, Oral Pathology, Oral and Maxillofacial Surgery, 구강병리학, 구강악안면외과학, 치의학

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