Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction – a preliminary study

Klesper, B; Lazar, Frank; Siessegger, Matthias; Hidding, J.; Zöller, Joachim E.

doi:10.1054/jcms.2002.0315

Cited by 36 publications

(25 citation statements)

References 17 publications

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“…Moreover, insufficient bone height in the symphyseal region precedes loss of chin projection and lip support. 15,20 The 'double barrel' technique 16,29 or alveolar distraction 30 can solve this problem. Otherwise, the vascularised iliac crest flap is an excellent option.…”

Section: Limited Height Of the Neomandiblementioning

confidence: 99%

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A treatment algorithm for managing giant mandibular ameloblastoma: 5-year experiences in a Paris university hospital

Chaine¹,

Pitak‐Arnnop²,

Dhanuthai³

et al. 2009

European Journal of Surgical Oncology (EJSO)

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. FINDINGS:Forty-four ameloblastoma patients were operated during this study period. Sixteen cases had GMA, of which 9 patients were included in this series (mean age: 35 years). The defects in the mandible ranged from 7 to 16 cm in length (mean: 12 cm). The average length of the harvested fibula was 11 cm, and the number of osteotomies ranged from 1 to 2. The mean ischemic time was 137 minutes (range: 90-180 minutes).Neck recipient vessels were used for flap perfusion in all cases. All but one flaps were viable without any complications, whilst partial skin-island necrosis occurred in 2 patients. Hospital stay was 2 weeks in most of the patients. No tumour recurrence was found during the follow-up period (range: 26-73 months). Dental implants were placed in 2 patients. CONCLUSIONS:Despite several limitations of this study, we suggest that a radical approach with the SM-IFFOFR is an effective treatment for GMA. Further well-designed, larger series with longer follow-up periods are still encouraged.

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Section: Limited Height Of the Neomandiblementioning

confidence: 99%

“…Fifth, as mentioned above, its limited height may dictate the use of the 'double barrel' technique 16,29 or alveolar distraction. 30 Finally, donor-site morbidities which include pain, muscle weakness, knee and ankle instability and foot numbness are possible, but rare. 4,5,16,19,20,29 …”

Section: Disadvantagesmentioning

confidence: 99%

A treatment algorithm for managing giant mandibular ameloblastoma: 5-year experiences in a Paris university hospital

Chaine¹,

Pitak‐Arnnop²,

Dhanuthai³

et al. 2009

European Journal of Surgical Oncology (EJSO)

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“…This is especially evident in cases of partial loss of dentate mandibles. The discrepancy between the graft and the intact alveolar bone at the unaffected site does not allow prosthetic rehabilitation with an implantbased denture or a complete implant-borne prosthesis (6)(7)(8)(9)(10)(11)(12). From a functional point of view, the implants need to support very long prosthetic suprastructures to reach the occlusal plane, with the risk of unfavourable bending moments and implant overload, which may jeopardize long-term implant survival.…”

Section: Discussionmentioning

confidence: 99%

“…This is a particular problem in the dentate mandible, especially when rehabilitation with dental implants is contemplated. Insufficient bone height leads to overloading of osseointegrated implants and jeopardizes the longevity of the prosthetic restoration (6)(7)(8)(9)(10)(11)(12). Distraction osteogenesis is performed in cases of vertical resorption of edentulous jaws to improve bone volume for dental implant placement (alveolar distraction).…”

Section: Introductionmentioning

confidence: 99%

Vertical distraction osteogenesis of a free vascularized fibula flap in a reconstructed hemimandible for mandibular reconstruction and optimization of the implant prosthetic rehabilitation. Report of a case

Cho-Lee

Naval-Gías²,

Martos-Díaz³

et al. 2011

Med Oral

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Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects (over 6 centimeters) resulting from trauma, infections or tumor resections. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma, for optimization of the implant prosthetic rehabilitation. The distraction device was applied intraorally. After 10 days of latency period, distraction protocol was performed at a distraction rate of 0.5 mm per day. A consolidation period of 3 months followed. Afterwards the distraction device was removed and 3 osseointegrated dental implants were placed in the distracted area. As a result, the vertical discrepancy between the fibula and the native hemimandible was corrected. The amount of vertical height achieved after distraction was 17 milimeters. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. In conclusion, we consider that vertical distraction osteogenesis of free vascularized flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation, after mandibular reconstruction following tumor surgery. Key words: Vertical distraction osteogenesis, free vascularized fibula flap, prosthetic rehabilitation.Cho-Lee GY, Naval-Gías L, Martos-Díaz PL, González-García R, Rodríguez-Campo FJ. Vertical distraction osteogenesis of a free vascularized fibula flap in a recons-tructed hemimandible for mandibular reconstruction and optimization of the implant prosthetic rehabilitation.

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“…Several authors have reported on successful cases of vertical DO of the fibula grafted to reconstruct the mandible 45) .…”

Section: Tissue Engineered Bone Enhance the Calcification Around The mentioning

confidence: 99%

Tissue engineered bone; Application for implant surgery

Ueda

2011

Inflammation and Regeneration

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Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction – a preliminary study

Cited by 36 publications

References 17 publications

A treatment algorithm for managing giant mandibular ameloblastoma: 5-year experiences in a Paris university hospital

A treatment algorithm for managing giant mandibular ameloblastoma: 5-year experiences in a Paris university hospital

Vertical distraction osteogenesis of a free vascularized fibula flap in a reconstructed hemimandible for mandibular reconstruction and optimization of the implant prosthetic rehabilitation. Report of a case

Tissue engineered bone; Application for implant surgery

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