Masticatory rehabilitation following upper and lower jaw reconstruction using vascularised free fibula flap and enossal implants—19 years of experience with a comprehensive concept

Abstract

This overview provides a reliable and comprehensive algorithm for standard implant-borne rehabilitation of patients with fibula grafts.

Oral rehabilitation with dental implants and quality of life following mandibular reconstruction with free fibular flap

“…Frequently, additional procedures are needed to improve the soft tissue situation around the implants prior to prosthetic rehabilitation. Local or extended vestibuloplasty procedures with or without partial skin grafts have been described and proved to be essential for long-term success of implant-borne rehabilitation [13,22]. These complementary procedures add another factor that might have an impact on quality of life and might be considered in further prospective studies.…”

“…Many more details of clinical and surgical aspects were recently described in this journal [13]. This is an independent study that has been approved by the local Ethics Committee of the study site (University of Luebeck).…”

Intraoral lining with the fibular osteomyofascial flap without a skin paddle during maxillary and mandibular reconstruction

“…Prosthodontic rehabilitation is the ultimate aim of jaw reconstruction, and many studies have provided clinical data on patient eligibility for dental rehabilitation using implants or conventional dentures followed by transplantation with free vascularized fibular osteocutaneous or osteomyocutaneous flaps . However, some questions have been raised during the clinical follow‐up of these patients with respect to the prosthetic reconstruction of the vertical height of the fibula and its soft tissue conditions.…”

“…Shaping and debulking are necessary, especially over the course of several procedures for implant or conventional denture placement . Meanwhile, chronic inflammation and hypertrophy in peri‐implant areas pose challenges for the long‐term management of peri‐implant soft tissues surrounding osteocutaneous or osteomyocutaneous flap reconstructions …”

Sub-Periosteal Dissection with Denture-Guided Epithelial Regeneration: A Novel Method for Peri-Implant Soft Tissue Management in Reconstructed Mandibles

“…In view of oral rehabilitation of these patients, this skin flap is a poor substitute for the attached oral mucosa as they are excessively bulky, mobile and of poor texture (often with the presence of hair appendages) [13,14]. Moreover, in between the fibula bone and the outer surface of the skin flap, there are layers of fat and muscle, which forms a compressible bed (much like a multi-layered mattress) when used as a support for prosthetic rehabilitation.…”