Sequential evaluation for bone union of transferred fibula flaps in reconstructed mandibles: panoramic X-ray versus computed tomography

Abstract The purpose of this study was to sequentially evaluate bone union of fibular grafts in mandibular reconstruction. Patients who underwent routine follow-up computed tomography (CT) and panoramic X-ray imaging during a period of ≥2 years were enrolled. On panoramic X-ray images, bone union wa...

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Bibliographic Details
Published in:International journal of oral and maxillofacial surgery 2015-08, Vol.44 (8), p.942-947
Main Authors: Akashi, M, Hashikawa, K, Kakei, Y, Sakakibara, A, Hasegawa, T, Minamikawa, T, Komori, T
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
bone union
Comorbidity
computed tomography
Dentistry
Female
Fibula - transplantation
free fibula osteocutaneous flap
Humans
Male
Mandibular Neoplasms - diagnostic imaging
Mandibular Neoplasms - therapy
Mandibular Reconstruction - methods
mandibulectomy
Middle Aged
panoramic X-ray
Radiography, Panoramic
Retrospective Studies
Surgery
Surgical Flaps
Tomography, X-Ray Computed
Treatment Outcome
Wound Healing - physiology
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Summary:Abstract The purpose of this study was to sequentially evaluate bone union of fibular grafts in mandibular reconstruction. Patients who underwent routine follow-up computed tomography (CT) and panoramic X-ray imaging during a period of ≥2 years were enrolled. On panoramic X-ray images, bone union was scored as 0 (absent callus formation) or 1 (complete callus formation). On CT images, a scale of 0 to 2 was used (0, absent callus formation; 1, complete callus formation only on the labial side; 2, complete callus formation on both the labial and lingual side). A total of 56 bone junctions were evaluated in 20 patients. Five of 56 junctions (9%) in four of 20 patients (20%) showed radiological non-union (panoramic X-ray score = 0, CT score = 0 or 1) at 2 years after surgery. All bone junctions with radiological non-union were located at the mandibular angle. No categorical values, including diabetes mellitus and radiation therapy, were significantly associated with radiological non-union. In conclusion, assessing at least two sides (i.e. labial and lingual sides) on CT images is adequate to evaluate bone union in transferred fibula flaps. Careful fixation at the mandibular angle may improve the rate of bone union.
ISSN:0901-5027
1399-0020
DOI:10.1016/j.ijom.2015.04.014