Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction

Background Functional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. The osteocutaneous fibula free flap in combination with simultaneous or second stage insertion of dental implants has exhibited growing popularity for such reconstructions. This study was aimed at evaluating the clinical status and the success rates of dental implants inserted in fibula-free flaps for orofacial reconstruction following ablation of tumors. Methods We conducted a clinical follow-up study based on 29 patients after oral tumor surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 5-year period. The follow-up protocol included clinical examination and radiological evaluation. The clinical records of the patients were reviewed retrospectively. Information on treatment modalities, dentition, implant parameters, and prostheses was collected and analyzed. Results In general, a high primary stability for implants placed into the free fibula grafts was achieved. The 1-year and 5-year cumulative survival rates of the implants were 96% and 91%, respectively, using the Kaplan-Meier method. The 1-year and 5-year cumulative success rates of implants respectively. The main reasons for failure of the dental proliferation. The fibula flap presents many advantages for implant-supported prosthetic rehabilitation difficult. placed into the fibula bone grafts were 95% and 87%, replants were infection, tumor recurrence and soft tissue implant placement, but its limited height sometimes makes Conclusions Vascularized fibula bone grafts provide a firm basis for the placement of dental implants in jaw reconstruction. Implants placed in fibula bone grafts were shown to integrate normally. The double-barrel technique, or increasing the height of the fibula flap by vertical distraction osteogenesis before implant placement in the mandible, is desirable from a functional and esthetic point of view.

Free flap transfer bridged by antegrade and retrograde posterior tibial vessel flaps temporally borrowed from the healthy leg

Objective: To study the methods and techniques of free flap transfer bridged by posterior tibial vascular flap in treating large soft tissue defects in low limbs without usable recipient blood vessels. Methods: Based on morphological observation and measurement of arterial pressure and blood flow, an antegrade and a retrograde vascular bridge flaps were designed using the healthy posterior tibial vessels to serve as vascular pedicles to carry two free flaps for transplantation. Results: Eight cases of patient with one or two large soft tissue defects in the leg region were treated by the method. All the bridge flaps and free flaps survived well, and the defects were repaired completely. Conclusions: The results showed that it is an ideal method for using the posterior tibial vessels from the healthy limb to form vascular pedicles in repairing large soft tissue defects in patients without a usable recipient blood vessel.