| Microsurgical reconstruction of the jaw with fibular grafts and implants. | |
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MedLine Citation:
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PMID: 19884849 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Reconstructive treatments for jaw defects are complex procedures that can combine multiple techniques including fibula free flap (FFF) grafting. The purpose of this retrospective study was to document and share our experience on mandibular and maxillar reconstruction with FFF followed by secondary dental rehabilitation using implant insertion.We reviewed 198 patients treated by FFF grafting for mandibular and/or maxillary defects in our department during the past 11 years (1996-2007). A selection of 30 patients (18 males and 12 females, mean age of 46 y) with adequate criteria (hygiene, motivation, and prognosis) received secondary placement of osseointegrated implants. The implant success was clinically and radiographically evaluated.A total of 105 osseointegrated implants were placed in the grafted fibulas 5 months to 3 years after the reconstruction surgery. Only 4 implants were lost because of peri-implantitis (3 patients) and fibular fracture (1 patient); this corresponds to a 96.2% implant success rate.During the mean follow-up of 76 months, patient's satisfaction and functional and aesthetic results were evaluated. Radiologic findings indicated a low crest resorption around the implants despite an unfavorable crown-to-root ratio.The main difficulties in the reconstructions were lack of FFF height, absence of a vestibular groove, limitation of mouth opening, skin paddle thickness, and the reconstruction of surrounding tissues including the lip. Our management strategy is discussed.Prosthetic choice is fundamental to achieving patient-specific solutions. The prostheses used included sealed or screwed bridge, resin-bonded bridge, tooled bar, implant-borne denture, or implant-stabilized dentures. Dental implants may be used even in situations involving an unfavorable crown-to-root ratio and implant position by using milled bar and overdenture. The FFF provides a consistent bone graft that allows a reliable and predictable restoration with dental implants, leading to a satisfactory functional and aesthetic restoration. |
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Authors:
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Gwénaël Raoul; Blandine Ruhin; Sondes Briki; Ludovic Lauwers; Guillaume Haurou Patou; Jean-Philippe Capet; Jean-Michel Maes; Joël Ferri |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of craniofacial surgery Volume: 20 ISSN: 1536-3732 ISO Abbreviation: J Craniofac Surg Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-12-03 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010410 Medline TA: J Craniofac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 2105-17 Citation Subset: D |
Affiliation:
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Oral and Maxillofacial Department, UDL, EA1049, Roger Salengro University Hospital, CHULille, F-59000 Lille, France. g-raoul@chru-lille.fr |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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