Bone remodeling of the modified vascularized free iliac flap in jaw reconstruction: preliminary longitudinal imaging observations.

OBJECTIVE

This preliminary study aimed to explore the postoperative bone remodeling patterns of the iliac bone after jaw reconstruction using a modified vascularized free iliac flap with preservation of the lateral cortical bone.

MATERIALS AND

METHODS

Patients undergoing jawbone reconstruction with the modified vascularized free iliac bone flap between January 2022 and February 2023 were recruited. Maxillofacial spiral CT scans were collected at 1 week, 6 months, and 1 year postoperatively. The nascent cortical bone thickness, total bone thickness, and cancellous bone density of the iliac bone flap were measured at three specified planes on the spiral CT images.

RESULTS

Seven patients were recruited for bone remodeling analysis. Cortical bone regeneration was observed in the iliac flap in all patients. At 1 year postoperatively, the mean cortical bone thickening at the three measurement planes was 1.18 mm, 1.17 mm, and 1.01 mm, respectively. Cancellous bone density at the same planes decreased by 59.9%, 57.4%, and 44.1% at 1 year compared with the 1-week levels.

CONCLUSIONS

The modified vascularized free iliac flap shows gradual increases in cortical bone thickness and total iliac bone thickness, along with a gradual decrease in cancellous bone density. The modified vascularized free iliac flap represents a viable alternative for jaw reconstruction.

CLINICAL RELEVANCE: The findings of this study provide valuable insights for the reconstruction of oral and maxillofacial defects in clinical practice.