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Maxillofacial reconstruction with prefabricated prelaminated osseous free flaps
Author(s) -
Diab Jason,
Leinkram David,
Wykes James,
Cheng Kai,
Wallace Christine,
Howes Dale,
Singh Jasvir,
Palme Carsten,
Clark Jonathan
Publication year - 2021
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.16541
Subject(s) - medicine , fibula , osseointegration , dentistry , implant , rehabilitation , free flap , mandible (arthropod mouthpart) , maxilla , retrospective cohort study , surgery , tibia , physical therapy , botany , biology , genus
Background The prefabricated fibula flap is an advanced method of occlusal‐based reconstruction that combines placement of osseointegrated dental implants with prelamination, using a split skin graft on the fibula, weeks prior to the definitive reconstruction. This approach is resource intensive but has several advantages including eliminating the delay from reconstruction to dental rehabilitation. Methods A retrospective cohort study of all prefabricated fibula flaps used for mandible and maxillary reconstruction from 2012 to 2020 was performed. Outcome measures were implant survival, implant utilization and functional dental rehabilitation. Results A total of 17 prefabricated fibula flaps were performed including two analogue and 15 digital plans. There were nine maxillary and eight mandibular reconstructions, of which 11 were primary and seven were secondary. There were no free flap failures. A total of 65 implants were placed (average 3.8, median 3 implants). There was one implant failure at 6 years giving a 1.5% failure rate. There was 91% implant utilization and 94% functional dental rehabilitation. Conclusion The prefabricated fibula flap provides outstanding dental rehabilitation in well‐selected patients.