Fc. Wei et al., MANDIBULAR RECONSTRUCTION WITH FIBULAR OSTEOSEPTOCUTANEOUS FREE-FLAP AND SIMULTANEOUS PLACEMENT OF OSSEOINTEGRATED DENTAL IMPLANTS, The Journal of craniofacial surgery, 8(6), 1997, pp. 512-521
Insertion of osseointegrated dental implants several months after mand
ibular reconstruction using vascularized composite bone grafts has pro
ved to be a successful method to achieve mastication and complete oral
rehabilitation. Theoretically with primary placement of implants into
the new mandible a better access to the bone is achieved, interdental
relationships are easier to determine, and oral rehabilitation can be
attained in a shorter period of time. Previous results describing thi
s approach, however, are inconclusive and controversial. This review d
escribes our experience with primary insertion of dental implants into
fibular flaps used for mandibular reconstruction during ablative surg
ery. Adequate selection of patients for this combined procedure depend
s mainly on the pathological nature of the mandible and perioperative
radiotherapy. Preoperative determination of soft-tissue and bone requi
rements, number of osteotomies, rigid fixation method, and familiarity
with the use of osseointegrated implants are important factors that m
ust be considered for adequate surgical planning and to achieve good r
esults.