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Bone impacted fibular free flap: A novel technique to increase bone density for dental implantation in osseous reconstruction
Author(s) -
Dziegielewski Peter T.,
Mlynarek Alex M.,
Harris Jeffrey R.,
Hrdlicka Adam,
Barber Brittany,
AlQahtani Khalid,
Wolfaardt John,
Raboud Don,
Seikaly Hadi
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23510
Subject(s) - medicine , implant , dentistry , dental implant , bone density , cortical bone , initial stability , surgery , anatomy , endocrinology , osteoporosis
Background Fibular free flap (FFF) bone has thick cortical bone surrounding a fatty marrow. The cortex has sufficient density for dental implantation, but the marrow limits bone stock. A novel technique was devised to increase bone density: the bone‐impacted fibular free flap (BIFFF). The purpose of this study was to: (1) describe the BIFFF technique; (2) evaluate the bone density of BIFFF; and (3) evaluate the stability/success of implants placed in BIFFFs. Methods Patients undergoing maxillary/mandibular reconstruction with FFFs were prospectively enrolled from 1998 to 2008. Two cohorts were compared: BIFFF and nonmodified FFF. The main outcome was bone density as seen on CT scans. Primary dental implant stability was determined via Periotest. Results Thirty‐eight patients were included in this study. BIFFFs achieved higher bone density versus unmodified FFFs ( p < .05). Greater primary dental implant stability occurred in BIFFFs ( p < .05). One hundred percent of BIFFF and 59% of nonmodified FFF implants were successful at 1 year. Conclusion BIFFF increases reconstructed bone density, initial dental implant stability, and 1‐year implant success. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1648–1653, 2014