VASCULARIZED BONE FLAPS IN OROMANDIBULAR RECONSTRUCTION - A COMPARATIVE ANATOMIC STUDY OF BONE STOCK FROM VARIOUS DONOR SITES TO ASSESS SUITABILITY FOR ENOSSEOUS DENTAL IMPLANTS

Objective: To identify donor sites from which vascularized bone may be harvested capable of accepting osseointegrated implants of the minimu m dimensions required to ensure long-term implant stability. Designs: An anatomic study of the most commonly employed donor sites for vascul arized bone in oromandibular reconstruction was conducted on 28 cadave rs. Setting: Academic tertiary referral center. Participants: Twenty-e ight freshly embalmed, adult white cadavers (16 male, 12 female) were dissected. Intervention: The ipsilateral fibula, iliac crest, radius, and lateral border of the scapula were harvested and multiply sectione d at predetermined sites. Outcome Measure: Implantability was determin ed for each section based on measurements of height, width, Results: T he iliac crest was the most consistently implantable donor site, follo wed by the scapula, fibula, and radius (83%, 78%, 67%, and 21% of sect ions from each donor site satisfying the criteria for implantability). Consistent regional differences in implantability were encountered Co nclusions: Following ablation of oromandibular malignant neoplasms, re storation of stable retentive dentition is a prerequisite to a success ful functional oral rehabilitation. This is best achieved with enosseo us implants, capable of supporting a stable dental prosthesis, placed directly into vascularized bone flaps at the time of mandibular recons truction. The implications of the results obtained in this study for g ender, donor site selection, and orientation of the vascularized bone flap are discussed.