Biomechanical loading test on reconstructed mandibles with fibular, iliac crest or scapula graft: a comparative study

Grohmann, Isabella; Raith, Stefan; Mücke, Thomas; Stimmer, Herbert; Rohleder, Nils H.; Kesting, Marco; Hölzle, Frank; Steiner, Timm

doi:10.1016/j.bjoms.2015.05.022

Cited by 21 publications

(10 citation statements)

References 24 publications

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“…They demonstrated [23]. There exists a diversity of results regarding stability, associated complications and costs of used fixation plates for the FFF and DCIA flap [24][25][26][27][28][29][30]. The bottom line of most manuscripts on this topic is that miniplate osteosynthesis remains the fixation system of choice for the FFF due to a low rate of associated complications and its good clinical handling.…”

Section: Frequency and Nature Of Complications Observedmentioning

confidence: 99%

Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study

et al. 2020

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Objectives The purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors. Materials and methods Clinical data and computed tomography scans of all patients who needed a mandibular reconstruction with a reconstruction plate, free fibula flap (FFF) or iliac crest (DCIA) flap between August 2010 and August 2015 were retrospectively analysed. Results One hundred and ninety patients were enrolled, encompassing 77 reconstructions with reconstruction plate, 89 reconstructions with FFF and 24 reconstructions with DCIA flaps. Cutaneous perforation was most frequently detected in the plate subgroup within the early interval and overall (each p = 0.004). Low body mass index (BMI) and total radiation dosage were the most relevant risk factors for the development of analysed complications. Conclusions Microvascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique. Clinical relevance A treatment algorithm for mandibular reconstructions on the basis of our results is presented.

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Section: Frequency and Nature Of Complications Observedmentioning

confidence: 99%

Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study

et al. 2020

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“…The author carried out a load test on the cadavers, who had reconstruction of the lower jaw with the above-mentioned flaps. The study confirmed that the lower jaw after reconstruction with free fibula presented the best result in the load test(Grohmann, Raith et al 2015). The estimated flap success rate varies with the literature data.…”

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confidence: 63%

Primary Oral Reconstructions with Microvascular Flaps in Patients with Oral Cancer in Advanced Stages, Impact on Survival and Quality of Life of Patients. Summary of the Doctoral Thesis

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“…Nowadays, the mechanical analysis of mandibular reconstruction with a vascularized free fibular flap mainly focuses on certain key methods of mandible reconstruction [37]. However, little is known concerning the type of mechanical distribution induced by different reconstruction methods, especially on the connections between bone segments.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Analysis of Various Reconstructive Methods for the Mandibular Body and Ramus Defect Using a Free Vascularized Fibula Flap

Jiang

Gao

et al. 2020

BioMed Research International

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Several different methods exist for reconstructing the mandibular body and ramus defect with the use of a free vascularized fibula flap, but none have adequately addressed the long-term mechanical stability and osseointegration. The aim of this study is to compare the biomechanics of different surgical methods and to investigate the best approach for reconstructing the mandibular body and ramus defect. Five finite element models based on different reconstructive methods were simulated. Stress, strain, and displacement of connective bone sections were calculated for five models and compared. The models were printed using a 3D printer, and stiffness was measured using an electromechanical universal testing machine. The postoperative follow-up cone beam computed tomography (CBCT) was taken at different time points to analyze bone mineral density of connective bone sections. The results showed that the "double up" (DU) model was the most efficient for reconstructing a mandibular body and ramus defect by comparing the mechanical distribution of three sections under vertical and inclined loading conditions of 100 N. The stiffness detection showed that stiffness in the DU and "double down" (DD) models was higher compared with the "single up" (SU), "single down" (SD), and "distraction osteogenesis" (DO) models. We used the DU model for the surgery, and postoperative follow-up CBCT showed that bone mineral density of each fibular connective section increased gradually with time, plateauing at 12 weeks. We conclude that a free vascularized fibula flap of the DU type was the best approach for the reconstruction of the mandibular body and ramus defect. Preoperative finite element analysis and stiffness testing were shown to be very useful for maxillofacial reconstruction.

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Biomechanical loading test on reconstructed mandibles with fibular, iliac crest or scapula graft: a comparative study

Cited by 21 publications

References 24 publications

Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study

Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study

Primary Oral Reconstructions with Microvascular Flaps in Patients with Oral Cancer in Advanced Stages, Impact on Survival and Quality of Life of Patients. Summary of the Doctoral Thesis

Biomechanical Analysis of Various Reconstructive Methods for the Mandibular Body and Ramus Defect Using a Free Vascularized Fibula Flap

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