Maxillofacial Reconstruction Using Vascularized Fibula Free Flaps and Endosseous Implants

Oral Maxillofac Surg Clin North Am. 2019 May;31(2):259-284. doi: 10.1016/j.coms.2018.12.005. Epub 2019 Mar 5.

Abstract

Maxillofacial subunit reconstruction using vascularized fibula free flap and endosseous implants is a complex and exciting topic. Use of this technique has profoundly improved patients' function, form, and quality of life. This article outlines the goals and requirements of reconstruction and patient selection. Current data are examined and issues related to flap selection, irradiation, primary versus secondary implant placement, timing and type of implants, use of virtual surgical planning, soft-tissue management, and prosthesis selection fabrication are discussed. Careful planning, communication, and collaboration between reconstructive surgeons and prosthodontists are critical in achieving optimal and stable long-term outcomes.

Keywords: Endosseous dental implants; Fibula free flap; Mandible; Maxilla; Prosthesis; Radiation; Reconstruction.

Publication types

  • Review

MeSH terms

  • Bone Transplantation / methods*
  • Dental Implantation, Endosseous / methods*
  • Fibula / transplantation*
  • Free Tissue Flaps / blood supply*
  • Humans
  • Mandible / surgery*
  • Mandibular Reconstruction / methods
  • Maxilla / surgery*
  • Maxillary Osteotomy
  • Plastic Surgery Procedures / methods*
  • Quality of Life
  • Surgical Flaps / blood supply
  • Treatment Outcome