Free fibula flap for reconstruction of the severely atrophic mandible: a retrospective study

The purpose of this retrospective study was to assess the feasibility of using a free fibula flap (FFF) for reconstruction of the alveolar region of the severely atrophic mandible, by determining bone stability after dental implant insertion and prosthetic rehabilitation in a series of eight female...

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Bibliographic Details
Published in:International journal of oral and maxillofacial surgery 2021-04, Vol.50 (4), p.546-554
Main Authors: Bulat, S., Butsan, S., Salikhov, K., Abramian, S., Arsenidze, A.
Format: Article
Language:English
Subjects:
Adult
Aged
Bone Transplantation
Dental Implantation, Endosseous
dental implants
Dentistry
Female
Fibula - surgery
fibula flap
Free Tissue Flaps
Humans
Mandible - surgery
mandibular atrophy
Mandibular Neoplasms - surgery
Mandibular Reconstruction
microsurgical
Middle Aged
reconstruction
Retrospective Studies
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Summary:The purpose of this retrospective study was to assess the feasibility of using a free fibula flap (FFF) for reconstruction of the alveolar region of the severely atrophic mandible, by determining bone stability after dental implant insertion and prosthetic rehabilitation in a series of eight female patients aged 36–65 years. Dental implant insertion was performed 3–4 months after reconstruction. Prosthetic loading was performed 3–4 months after implant insertion. The height of the reconstructed mandible after surgery was 21.20±1.87mm, with an increase of 8.80±1.71mm from the preoperative height. The height of the FFF immediately after reconstruction was 11.24±1.10mm; this showed a vertical loss of 0.99±0.52mm (8.79%) and maintenance of 91.21% of the initial height at a mean 14 months post-reconstruction. Applying the Wical and Swoope formula to estimate the original mandibular body height, it was found that the difference between this calculated height (21.17±3.76mm) and the reconstructed height (21.20±1.87mm) was only 0.03±3.17mm (0.14%). An overall insignificant decrease of 0.46±1.14 cm3 in FFF volume had occurred at 3–4 months after dental implant functional loading, while in two cases an increase in volume was found (1.22cm3 and 1.71cm3). The good and stable results obtained show that the FFF may be used to reconstruct the whole mandibular alveolar region, with the best possible outcomes.
ISSN:0901-5027
1399-0020
DOI:10.1016/j.ijom.2020.08.005