Evolution of the mandibular defects reconstruction with free fibula flapx

Butsan, S.B.; Gileva, K.S.; Verbo, E.V.; Khokhlachev, S.B.; Abramian, S.; Smal, A A; Bulat, S.G.

doi:10.17116/stomat201897335

Cited by 4 publications

(2 citation statements)

References 14 publications

(10 reference statements)

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“…In addition to these four types, another type of reconstruction, termed "distraction osteogenesis" (DO), consists of a single fibula flap fixed to the lower margin of the mandible, where the height of the alveolar bone is distracted by oblique distraction osteogenesis to meet the requirement of a dental implant [24]. The five methods mentioned above are all used in current surgical practice [25].…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…Accelerating mobility and speed of modern society, the spread of weapons and military conflicts, there is a growing incidence of post-traumatic deformities of various origin affecting bones. The corresponding surgical reconstruction requires a more sofisticated and comprehensive approach [2,5,10,13,16].…”

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confidence: 99%

Reconstruction of Mandibular Defects Using Individual Vascularized Autografts Combined With Macroporoustitanium Fiber Ma

Байриков¹,

Gaivoronskaya²,

Dedikov³

et al. 2021

AREM

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— The choice of donor material poses a problem for surgeons handling reconstruction of large combined bone defects or limited maxillofacial bone defects. Restoration methods, applicable in reconstructive microsurgery are based on materials of non-biological origin and musculoskeletal autogenous transplants which have complications and may inhibit the processes of osseointegration. Our study aimed to improve the efficiency of surgical treatment and rehabilitation of patients with mandibular defects using vascularized autograft in combination with macroporous titanium fiber material. The reconstruction of the defective mandible caused by chronic osteomyelitis, trauma, benign tumors was performed in 107 patients either by means of conventional methods (titanium plates, free and vascularized bone autografts), or by a novel engineered bone substitute. Our novel vascularized bone autotransplant combines a macroporous fiber titanium material and spiral bone autochips. For its fabrication we applied digital 3D technologies and methods of rapid prototyping, whereas its vascularization was harvested in iliac crest. Unlike the standard methods of reconstruction, the use of the engineered vascularized implant showed a significant reduction in stages, volume and invasiveness of surgical procedures and an improvement of esthetic and functional outcomes in patients with mandibular defects.

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Dental rehabilitation in the complex treatment of children and adolescents with maxillofacial neoplasms

Markov

Grachev

Babaskina

et al. 2020

Stomat.

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Evolution of the mandibular defects reconstruction with free fibula flapx

Cited by 4 publications

References 14 publications

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

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

Reconstruction of Mandibular Defects Using Individual Vascularized Autografts Combined With Macroporoustitanium Fiber Ma

Dental rehabilitation in the complex treatment of children and adolescents with maxillofacial neoplasms

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