Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note

Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar con...

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Bibliographic Details
Published in:Dentistry journal 2019-06, Vol.7 (3), p.65
Main Authors: Akashi, Masaya, Matsumoto, Kousuke, Takeda, Daisuke, Yamashita, Junya, Yatagai, Nanae, Hashikawa, Kazunobu, Komori, Takahide
Format: Article
Language:English
Subjects:
Ablation
Case Report
custom titanium bar
Dental implants
Dental materials
Dental prosthetics
Dentures
Epithelium
Fibrin
Fibula
free fibula flap
Implants
Lasers
Mandible
Osseointegration
Periosteum
Plastic surgery
Polyglycolic acid
polyglycolic acid sheet
Prostheses
Rehabilitation
Skin & tissue grafts
skin graft
Sutures
Titanium
vestibuloplasty
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Summary:Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application of a polyglycolic acid (PGA) sheet is described. The implants were inserted into a viable fibula flap with severe scar contracture of the overlying epithelium resulting from vascular instability in skin paddle. Only the fibula periosteum was sutured after implant insertion; exposed surfaces were covered with a combination of PGA sheet and fibrin sealant. The area with PGA sheet coverage gradually healed with moderate contracture. The epithelium around the almost implants became immobilized. The implant-supported removable partial denture with custom titanium bar was acceptable. Dental rehabilitation is possible for reconstructed mandibles with severe scar contracture. Application of a PGA sheet may be useful for vestibuloplasty in patients with reconstructed mandibles.
ISSN:2304-6767
2304-6767
DOI:10.3390/dj7030065