Mandibular reconstruction in the young adult using free vascularized iliac crest

Abstract

Five young adults between the ages of 16 and 27 years underwent mandibular reconstruction with free vascularized iliac crest bone grafts based on the deep circumflex iliac artery. These were the only patients under age 30 years in a series of over 60 patients undergoing this procedure. In all cases, the ipsilateral crest was employed, and special efforts were made to minimize bony bulk by removing the outer cortex and carefully shaping the graft. The bone graft underwent final trimming in situ, the exact dimensions being reproduced from measurements taken from the excised specimen. When bone alone requires replacement, as in the majority of young patients, an excellent functional result can be anticipated. Occlusion can be maintained or even restored, and the normal facial contour can be re-established. Osteointegrated implants hold out the possibility of providing full dental rehabilitation in an age group in which anything less is considered failure. Furthermore, the donor site scar can be hidden by a bathing suit. It is concluded that this form of reconstruction is particularly suitable for the young adult, in whom cosmesis, function, donor site, and freedom from long-term complications are of supreme importance.

Surgical Ablation and Free Flap Reconstruction in Children with Malignant Head and Neck Tumors

“…There was no need for a feeding gastrostomy in any of Although data on free flap reconstruction in adults are abundant, [1][2][3] few studies have assessed the feasibility of free tissue transfer in children. [4][5][6][7] All of the available studies are retrospective reviews, and the cohorts are relatively small, probably due to the rarity of the disease, which is usually treated nonsurgically.…”

“…Other concerns are related to the challenges of performing microsurgery in children whose blood vessel diameters are small, anatomic landmarks are inconsistent, and growth of anastomosed vessels is anticipated. Several retrospective studies [4][5][6][7] have been conducted to understand the special considerations related to this age group, but the sample sizes were small, and data on the therapeutic management of children with malignant tumors are limited.…”

Survival of Dental Implants in Irradiated Head and Neck Cancer Patients: A Retrospective Analysis

“…These implants can be placed either in native bone or in grafted bone depending on the extent of the defect and restorative treatment plan. Bone grafts typically used for reconstruction include iliac crest, 4 scapula, rib, and fibula 5 …”

“…3 These implants can be placed either in native bone or in grafted bone depending on the extent of the defect and restorative treatment plan. Bone grafts typically used for reconstruction include iliac crest, 4 scapula, rib, and fibula. 5 Whether dental implants are placed in native or grafted bone, radiation exposure may cause a delay in wound healing.…”

Microvascular reconstruction of mandibular defects in paediatric patients

“…Many authors have expressed concern regarding harvesting of this flap (Boyd, 1988), with disruption of several pelvic muscular insertions, and suggest using other donor sites to avoid the risk of gait disturbance (Laurie et al, 1984). Neither of our two patients reconstructed with this technique showed gait disturbance or radiological findings of pelvis anomalies, and both reported a complete return to normal life activities after treatment.…”