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Sandwich osteotomy for 18 patients with insufficient fibular height after mandibular reconstruction using vascularized single-barrel free fibular flap: a retrospective study.

The insufficient fibular height after mandibular reconstruction using vascularized single-barrel free fibular flap is a Gordian knot for implantation. Numerous studies have demonstrated that sandwich osteotomy is an effective technique for bone augmentation,so it is worth investigating whether it can achieve the same result used for transplanted fibula.A total of 18 patients were retrospectively enrolled. All patients underwent single-barrel free fibula flap repair for segmental mandibular defects but the fibular height was not sufficient for subsequent implantation, so sandwich osteotomy was …

Biphasic calcium phosphate doped with zirconia nanoparticles for reconstruction of induced mandibular defects in dogs: cone-beam computed tomographic and histopathologic evaluation.

The present study aimed to evaluate osteogenic potential and biocompatibility of combining biphasic calcium phosphate with zirconia nanoparticles (4Zr TCP/HA) compared to biphasic calcium phosphate (TCP/HA) for reconstruction of induced mandibular defects in dog model. TCP/HA and 4Zr TCP/HA scaffolds were prepared. Morphological, physicochemical, antibacterial, cytocompatibility characterization were tested. In vivo application was performed in 12 dogs where three critical-sized mandibular defects were created in each dog. Bone defects were randomly allocated into: control, TCP/HA, and 4Zr TCP

Reconstruction of mandibular vertical defects for dental implants with autogenous bone block grafts using a tunnel approach: clinical study of 50 cases.

The objective of this study was to evaluate the outcomes of mandibular vertical defect reconstruction with autologous bone and the use of a sub-periosteal tunnel approach in preparation for dental implant insertion. Forty-three consecutive patients with an atrophic posterior mandible were reconstructed using this method. Two thin laminae of cortical bone, obtained by splitting blocks harvested from the retromolar area, were fixed in a box-like framework containing cancellous and particulate bone. The goal was to achieve an alveolar ridge width of ≥5.5mm and an effective bone height (EBH) of ≥1

Esthetic outcome and tissue stability of maxillary anterior single-tooth implants following reconstruction with mandibular block grafts: a 5-year prospective study.

PURPOSE: The aim of this prospective study was to evaluate the hard and soft tissue stability and esthetic outcomes of single-tooth implants placed in the anterior atrophic maxilla, following augmentation with mandibular block grafts covered with bovine hydroxyapatite and a resorbable collagen membrane, over a 5-year period. MATERIALS AND METHODS: Patients with a bony deficiency of ≥ 3 mm horizontally and ≤ 3 mm vertically were treated consecutively with reconstructive procedures and implant placement 6 months afterward. Alveolar ridge dimensions were measured before and after augmentation us

[Mandibular reconstruction using an iliac crest free flap vascularized by the deep circumflex iliac vessels. A clinical study apropos of 30 cases].

Thirty cases of mandibular defects were reconstructed with a free iliac flap vascularised by the deep circumflex iliac vessels. Twenty five of these cases involved soft tissue damage with a defect of the mandible. The surgical procedure described by I. Taylor was used. Three anatomical variations of the pedicle were found. The features of the iliac bone are particularly suitable for mandibular reconstruction. The natural shape of the iliac bone does not require complex osteotomies and its healing capacity allows simple osteosynthesis. The thickness of the muscular pedicle, and thus the flap, i…

Posterior airway space following mandibular reconstruction using microvascular free flaps in oral cancer patients in relation to radiotherapy: a single-center study.

INTRODUCTION: The posterior airway space (PAS) is of considerable clinical relevance, as airway obstruction in this region may compromise patient well-being, manifesting as symptoms ranging from acute dyspnea to chronic obstructive sleep apnea. Although previous studies have demonstrated significant alterations in the PAS following oral and maxillofacial surgical procedures, changes in the PAS among patients with oral cancer undergoing microvascular reconstruction remain insufficiently investigated. This study aimed to evaluate changes in PAS following mandibular resection and microvascular fr

Finite element analysis of stress distribution after folded and single-layer fibular reconstruction with implant restoration for brown class Ⅱ mandibular defects.

OBJECTIVE: This study aimed to compare the stress distribution after folded and single-layer fibular reconstruction with implant-supported restoration for Brown Class Ⅱ mandibular defects using finite element analysis (FEA), to provide a theoretical basis for selecting an optimal mandibular reconstruction strategy in clinical practice. METHODS: A healthy adult female volunteer from Bengbu Medical University underwent spiral computed tomography (CT) scans of the mandible and fibula. The CT data were imported into Mimics 21.0 software to reconstruct three-dimensional models of the intact mandib…

Strategic Muscle Coverage in Free Fibular Mandibular Reconstruction: An Osteotomy Approach to Minimize Plate Exposure, A Retrospective Analysis of 580 Consecutive Patients.

BACKGROUND: Free fibula flap reconstruction represents the gold standard for mandibular reconstruction following oncologic resection. However, plate exposure remains a significant complication, particularly in patients receiving postoperative radiotherapy. Traditional reconstructive approaches emphasize precise hardware contouring and basic soft tissue coverage but frequently fail to provide adequate muscle protection over hardware, especially in irradiated tissues. METHODS: A retrospective analysis was conducted of 580 consecutive free fibula flap reconstructions performed between 2018 and 2…

Vascularized Chin Fat Flap for Mandibular Reconstruction in Stable Scleroderma En Coup De Sabre: A Case Report and Review of Surgical Considerations.

Scleroderma en coup de sabre (ECDS) is a rare form of linear scleroderma that typically causes progressive atrophy on the face, which can affect both appearance and function over time. Although various reconstructive strategies exist, the use of a vascularized chin fat flap (CFF) for mandibular soft tissue restoration has not been previously reported. We describe a 61-year-old woman with stable ECDS and anterior mandibular depression. After disease stabilization with methotrexate, a pedicled fat flap was harvested from the submental region and inset via a single incision while preserving its n

Short-term outcomes of mandibular reconstruction in oncological patients using a CAD/CAM prosthesis including a condyle supporting a fibular free flap.

PURPOSE: Condylar reconstruction and replacement using alloplastic materials currently attracts much surgical interest. The major challenge is to functionally reconstruct the anatomical region; this is crucial in terms of correct mandibular function. The goal of the present study was to evaluate the clinical outcomes of and complications experienced by a series of oncological patients who underwent computer-aided design/computer-aided manufacturing (CAD/CAM) condylar reconstruction following resection-disarticulation of the mandible. MATERIALS AND METHODS: We included nine patients who underw

Secondary reconstruction for mandibular osteoradionecrosis defect with fibula osteomyocutaneous flap flowthrough from radial forearm flap using stereolithographic 3-dimensional printing modeling technology.

Osteoradionecrosis (ORN) is one of the most serious complications of oral and nasopharyngeal malignant neoplasms after radiotherapy. The incidence of mandibular ORN is significantly higher than that of maxilla. A radical surgical intervention such as mandibulectomy for advanced ORN is appropriate and effective to relieve pain and control infection. However, recovery of functionality and aesthetics is usually not the primary purpose of the one-stage radical surgery. Some patients often need a 2-stage operation owing to the bone defect, scar contracture, or recurrence. Although free flap has bee

The influence of secondary reconstruction slice thickness on NewTom 3G cone beam computed tomography-based radiological interpretation of sheep mandibular condyle fractures.

OBJECTIVE: The objective of this study was to examine the diagnostic accuracy of the different secondary reconstruction slice thicknesses of cone beam computed tomography (CBCT) on artificially created mandibular condyle fractures. METHODS: A total of 63 sheep heads with or without condylar fractures were scanned with a NewTom 3G CBCT scanner. Multiplanar reformatted (MPR) views in 0.2-mm, 1-mm, 2-mm, and 3-mm secondary reconstruction slice thicknesses were evaluated by 7 observers. Inter- and intraobserver agreements were calculated with weighted kappa statistics. The receiver operating char

Patient-specific guided Deep Circumflex Iliac Artery free flap for mandibular reconstruction in an ameloblastoma case. Case report and insights on the current state of customized surgery in H&N reconstruction in China.

This article presents a case of recurrent mandibular ameloblastoma treated with customized reconstructive surgery using a microvascularized DCIA bone flap. Virtual surgical planning and customized surgery, which has become increasingly adopted in head and neck reconstruction, enhances precision in tumor resection, flap design, and fixation, leading to superior functional and aesthetic outcomes. The patient, initially treated with curettage in China (2017) and Japan (2021), presented with recurrence upon relocating to Shanghai. Imaging confirmed the diagnosis, and customized surgery was planned

Implant-supported overdenture placement after fibula flap-based mandibular reconstruction using guided bone regeneration with titanium mesh and tenting screws: A clinical report.

A 63-year-old man underwent segmental mandibulectomy for ameloblastoma, followed by fibula free-flap reconstruction. As the bone volume was inadequate, guided bone regeneration (GBR) was performed using iliac particulate cancellous bone and marrow, titanium mesh, and tenting screws. After consolidation, 4 implants were placed, and restoration was completed with a computer-aided design and computer-aided manufacturing titanium bar and LOCATOR-retained overdenture. This staged approach ensured stable implant placement and successful rehabilitation. At 1 year postoperatively, the patient's appear

Fibula flap versus soft tissue flap with reconstruction plate for mandibular stage 3 medication-related osteonecrosis of the jaw: a retrospective cohort study.

BACKGROUND: With the increasing incidence of medication-related osteonecrosis of the jaw (MRONJ), the choice of reconstruction method for mandibular stage 3 MRONJ remains controversial. This study aimed to compare the outcomes of fibula flap (FF) and soft tissue flap with reconstruction plate (SR) in patients with mandibular stage 3 MRONJ. METHODS: This retrospective cohort study included patients diagnosed with mandibular stage 3 MRONJ who underwent reconstruction between September 2018 and May 2024. Patients were categorized into the FF and SR groups. Demographic and general characteristics,

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… Molteni G Gazzini L Sacchetto A Nocini R Comini LV Arietti V Locatello LG Mannelli G Mandibular reconstruction in head and neck cancer: which is the gold standard? … Mandibular reconstruction in head and neck cancer: which is the gold standard? Eur Arch Otorhinolaryngol. 2023;280(9):3953–65. 10.1007/s00405-023-08050-5. 37269408 10.1007/s00405-023-08050-5 18. …

[Modified submental artery island flap for reconstruction of mandibular defects caused by medication-related osteonecrosis of the jaw: technical note and clinical outcomes].

Objective: To summarize the key surgical techniques of the modified submental artery island flap for repairing tissue defects following surgery for mandibular medication-related osteonecrosis of the jaw (MRONJ), and to retrospectively evaluate the therapeutic outcomes. Methods: A total of 116 patients with mandibular MRONJ who underwent surgical treatment at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Peking University International Hospital, and Baoding Second Hospital from June 2021 to September 2025 were included. All patients unde

Determination of adequate bony resection margins in inflammatory jaw pathologies using SPECT-CT in primary mandibular reconstruction with virtually planned vascularized bone flaps.

OBJECTIVES: In advanced stages of osteoradionecrosis, medication-related osteonecrosis of the jaw, and osteomyelitis, a resection of section … ODS: The cases of 20 patients with inflammatory jaw pathologies who underwent primary microvascular mandibular reconstruction after the bony resection margins were determined with SPECT-CT were retrospectively analyzed. The bony resection margins determined by SPECT-CT were histologically validated. The sensitivity was calculated as the detection rate and the positive pred …

Progress of Ossification after Mandibular Reconstruction by Free Fibula Flap Depending on Different Timing of Radiotherapy: A Retrospective 3D Analysis by CT Scans.

Background: The aim of this study was to evaluate the difference between pre- and post-operative radiotherapy on the progress of ossification after free fibula flap reconstruction of the mandible using three-dimensional (3D) analysis. Methods: A total of 38 free fibula reconstructions of the mandible were evaluated retrospectively for ossification between bone segments by measuring Hounsfield Units (HU) in at least two postoperative computer tomography scans (average of 2.4 scans per patient; around the 5th, 12th, 16th, and 19th month postoperative). Three subgroups were created according to t

Assessment of functional improvement with implant-supported prosthetic rehabilitation after mandibular reconstruction with a microvascular free fibula flap: A study of 25 patients.

STATEMENT OF PROBLEM: Mandibular reconstruction with a microvascular free fibula flap is widely used after oncologic resection because it allows functional and esthetic restoration of the mandibular arch and implant-retained prostheses. PURPOSE: The purpose of this study was to highlight the results that can be expected from an implant-supported prosthesis on a free fibula flap. MATERIAL AND METHODS: Patients treated with a microvascular free fibula flap and rehabilitated prosthetically were included. The number of osteotomies, number of implants, type of prosthesis, follow-up after placemen…

The local pulsatile parathyroid hormone delivery system induces the osteogenic differentiation of dental pulp mesenchymal stem cells to reconstruct mandibular defects.

BACKGROUND: Tumors and injuries often lead to large mandibular defects. Accelerating the osteogenesis of large bone defect areas is a major concern in current research. In this study, dental pulp mesenchymal stem cells (DPSCs) were used as seed cells, and the local pulsatile parathyroid hormone (PTH) delivery system was used as an osteogenic-inducing active ingredient to act on DPSCs and osteoblasts, which were applied to the jaw defect area to evaluate its therapeutic effect on bone regeneration. METHODS: Pulsatile delivery systems, both with and without PTH, were developed following the pro