Microvascular reconstruction and dental rehabilitation of benign severely atrophic jaws and defects of the alveolar ridge: our philosophy in 2019

Gian Battista Bottini; Christian Brandtner; Christoph Steiner; Jörn Wittig; Felix Hartig; Corina List; Alexander Gaggl

doi:10.1016/j.bjoms.2019.01.002

Microvascular reconstruction and dental rehabilitation of benign severely atrophic jaws and defects of the alveolar ridge: our philosophy in 2019

Br J Oral Maxillofac Surg. 2019 Feb;57(2):151-156. doi: 10.1016/j.bjoms.2019.01.002. Epub 2019 Jan 23.

Authors

Gian Battista Bottini¹, Christian Brandtner², Christoph Steiner³, Jörn Wittig⁴, Felix Hartig⁵, Corina List⁶, Alexander Gaggl⁷

Affiliations

¹ Department of Oral and Maxillofacial Surgery, University Hospital of the Private Medical University Paracelsus, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. Electronic address: g.bottini@salk.at.
² Department of Oral and Maxillofacial Surgery, University Hospital of the Private Medical University Paracelsus, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. Electronic address: c.brandtner@salk.at.
³ Department of Oral and Maxillofacial Surgery, University Hospital of the Private Medical University Paracelsus, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. Electronic address: c.steiner@salk.at.
⁴ Department of Oral and Maxillofacial Surgery, University Hospital of the Private Medical University Paracelsus, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. Electronic address: j.wittig@salk.at.
⁵ Department of Oral and Maxillofacial Surgery, University Hospital of the Private Medical University Paracelsus, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. Electronic address: f.hartig@salk.at.
⁶ Department of Oral and Maxillofacial Surgery, University Hospital of the Private Medical University Paracelsus, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. Electronic address: corina.list@wienkav.at.
⁷ Department of Oral and Maxillofacial Surgery, University Hospital of the Private Medical University Paracelsus, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. Electronic address: a.gaggl@salk.at.

PMID: 30685182
DOI: 10.1016/j.bjoms.2019.01.002

Abstract

We deal regularly with patients who present with severe atrophy of the jaws, compromised soft tissue, or penetrating defects of the alveolar ridge that are not the result of malignant disease. For these patients we use microvascular bony flaps together with dental implants and implant-supported prostheses. The purpose of this retrospective study was to present our current management and the lessons we have learned over a 16-year period while treating 86 patients for these indications with 87 microvascular bone flaps. We used a transoral approach for the anastomosis in 60 flaps, thereby avoiding visible scars, and inserted 281 dental implants to support fixed or removable dental prostheses. Two femoral flaps developed partial necrosis, and seven implants were lost. Eighty-five of the 86 patients were satisfied with the improvement in their orofacial function and aesthetics. Poor oral hygiene, active osteomyelitis, and severe bruxism are absolute contraindications.

Keywords: alveolar ridge defect; dental implants; dental rehabilitation; free flap; jaw atrophy; microvascular reconstruction.

MeSH terms

Alveolar Bone Loss
Alveolar Process*
Alveolar Ridge Augmentation
Atrophy
Dental Implantation, Endosseous
Dental Implants*
Dental Prosthesis, Implant-Supported
Humans
Retrospective Studies
Treatment Outcome

Substances

Dental Implants