Comparisons of bone volumes and densities relating to osseointegrated implants in microvascularly reconstructed mandibles: a study of cadaveric radius and fibula bones

The study was designed to compare the dimensions and densities of two frequ ently used bone donor sites with regard to placement of endosseous dental i mplants in microvascularly reconstructed mandibles. A total of 40 radii and of 40 fibulae were investigated. Fifty two percent of the fibulae had adeq uate bone volume for the positioning of four 10 mm implants, while this fig ure was 55% for the radii. After using the 'double barrel' technique the pl acement of four 10 mm implants succeeded in 87% of all the fibulae, Due to the lack of bone length required, this special technique was not possible i n the radii investigated. Cortical thickness and density of bone were highe r in the radii when compared with the fibulae. In each bone the central and distal parts presented the highest values of cortical thickness and densit y. Although the radius offers enough substantial bone for implant placement in some cases this cannot be used for clinical purpose, as only hemicortic al grafts can be obtained. Otherwise the resulting donor site morbidity wou ld be intolerable. In conclusion, our results support the clinical experien ce that the fibula is today's 'work horse' donor site for reconstruction of the mandible. (C) 2000 European Association for Cranio-Maxillofacial Surge ry.