Rehabilitation of long‐term mandibular defects by whole‐process digital fibula flap combining with implants: A case report

Li, Jian; Li, Xue; Ma, Kai; Sun, Jian; Bai, Na; Liu, Yanshan

doi:10.1111/jopr.13627

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Cuellar et al [ 15 ], Margabandu [ 34 ], Paranque [ 35 ], and Ruhin [ 37 ] opted for delayed implants. A total of nine studies [ 25 , 26 , 27 , 28 , 30 , 33 , 38 , 39 , 40 ] performed an immediate implant placement. Shen et al [ 38 ] and Wang et al [ 40 ] opted for both options, immediate and deferred rehabilitation, the former in three patients and the latter in one patient, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…In a total of 76 patients studied, good to excellent aesthetic results were achieved describing a standardized protocol for measuring the aesthetic results in a quantitative and score-based fashion (Chen et al [ 31 ], Margabandu et al [ 34 ], and Shen et al [ 38 ]). Antunez-Conde [ 25 ], Berrone [ 26 ], Chang [ 28 ], Li [ 33 ], Qu [ 36 ], and Ruhin [ 37 ] mentioned the aesthetic results in a qualitative manner, achieving a satisfactory facial contour and good aesthetic results. Bianchi [ 27 ], Chang [ 29 ], Chang [ 30 ], Cuellar [ 15 ], Paranque [ 35 ], and Trilles [ 39 ] only mentioned the aesthetic results of their patients in their discussion and/or conclusion.…”

Section: Resultsmentioning

confidence: 99%

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Reconstruction of Segmental Mandibular Defects with Double-Barrel Fibula Flap and Osseo-Integrated Implants: A Systematic Review

Khayat,

Sada Urmeneta,

González Moure

et al. 2024

JCM

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Background: Mandibular defects resulting from oncological treatment pose significant aesthetic and functional challenges due to the involvement of bone and soft tissues. Immediate reconstruction is crucial to address complications such as malocclusion, mandibular deviation, temporomandibular joint (TMJ) changes, and soft tissue retraction. These issues can lead to functional impairments, including difficulties in chewing, swallowing, and speech. The fibula flap is widely used for mandibular reconstruction due to its long bone segment and robust vascular supply, though it may not always provide adequate bone height for optimal dental rehabilitation. This systematic review aims to determine if the double-barreled fibula flap (DBFF) configuration is a viable alternative for mandibular reconstruction and to evaluate the outcomes of dental implants placed in this type of flap. Materials and Methods: This study adhered to the Cochrane Collaboration criteria and PRISMA guidelines and was registered on the International Platform of Registered Systematic Review and Meta-Analysis Protocols Database (INPLASY2023120026). We included clinical studies published in English, Spanish, or French that focused on adult patients undergoing segmental mandibulectomy followed by DBFF reconstruction and dental rehabilitation. Data sources included Medline/PubMed, the Cochrane Library, EMBASE, Scopus, and manual searches. Two reviewers independently screened and selected studies, with discrepancies resolved by a third reviewer. Data extraction captured variables such as publication year, patient demographics, number of implants, follow-up duration, flap survival, implant failure, and aesthetic outcomes. The risk of bias was assessed using the JBI appraisal tool, and the certainty of evidence was evaluated using the GRADE approach. Results: A total of 17 clinical studies were included, evaluating 245 patients and 402 dental implants. The average patient age was 43.7 years, with a mean follow-up period of 34.3 months. Flap survival was high, with a 98.3% success rate and only four flap losses. The implant failure rate was low at 1.74%. Esthetic outcomes were varied, with only three studies using standardized protocols for evaluation. The overall certainty of evidence for flap survival was moderate, low for implant failure, and very low for aesthetics due to the subjective nature of assessments and variability in reporting. Conclusions: The primary limitations of the evidence included in this review are the observational design of the studies, leading to an inherent risk of bias, inconsistency in reporting methods, and imprecision in outcome measures. Additionally, the subjective nature of aesthetic evaluations and the variability in assessment tools further limit the reliability of the findings. The DBFF technique demonstrates excellent outcomes for mandibular reconstruction, with high flap survival and low implant failure rates, making it a viable option for dental rehabilitation. However, the evidence for aesthetic outcomes is less certain, highlighting the need for more rigorous and standardized research. This review supports the DBFF as a good alternative for mandibular reconstruction with successful dental implant integration, although further studies are needed to enhance the reliability of aesthetic evaluations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Reconstruction of Segmental Mandibular Defects with Double-Barrel Fibula Flap and Osseo-Integrated Implants: A Systematic Review

Khayat,

Sada Urmeneta,

González Moure

et al. 2024

JCM

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show abstract

“…Since Hidalgo introduced free tissue transplantation to restore jaw defects ( Hakim et al, 2015 ), vascularized fibula flaps have been widely considered the gold standard for mandibular reconstruction ( Srivastava et al, 2022 ) due to their multiple advantages. When the vascularized upper layer of the double-layer fibula is suitable for implantation, the lower layer can effectively restore facial contour and provide better support for soft tissues ( Li et al, 2023a ). However, mandibular reconstruction is a complex task.…”

Section: Introductionmentioning

confidence: 99%

Application of 3D printed titanium mesh and digital guide plate in the repair of mandibular defects using double-layer folded fibula combined with simultaneous implantation

Li,

Mi,

Bai

et al. 2024

Front. Bioeng. Biotechnol.

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Fibula transplantation plays an irreplaceable role in restoring the function and morphology of the defected mandible. However, the complex load-bearing environment of the mandible makes it urgent to accurately reconstruct the mandible, ensure the position of the condyle after surgery, and restore the patient’s occlusal function and contour. The intervention of digital design and three-dimensional (3D) printed titanium mesh provides a more efficient method and idea to solve this problem. Digital design guides the accurate positioning, osteotomy, and simultaneous implant placement during surgery, and 3D printed titanium mesh ensures stable condyle position after surgery, restoring good mandibular function. The double-layer folded fibula maintains the vertical height of the mandible and a good facial contour, and simultaneous implant placement can establish a good occlusal relationship. This study conducted a retrospective analysis of five patients with jaw defects who underwent digital fibula reconstruction over the past 3 years. It was found that the surgical protocol combining digital design, 3D printed intraoperative guides, 3D printed titanium mesh, free fibula flap, immediate implant, and occlusal reconstruction to repair jaw defects had more ideal facial appearance and biological function. It will provide a more reliable surgical protocol for clinical management of large mandibular defects.

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3D printing materials and 3D printed surgical devices in oral and maxillofacial surgery: design, workflow and effectiveness

Wang,

Mu,

Yan

et al. 2024

Regenerative Biomaterials

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Oral and maxillofacial surgery is a specialized surgical field devoted to diagnosing and managing conditions affecting the oral cavity, jaws, face, and related structures. In recent years, the integration of 3D printing technology has revolutionized this field, offering a range of innovative surgical devices such as patient-specific implants (PSIs), surgical guides, splints, bone models, and regenerative scaffolds. In this comprehensive review, we primarily focus on examining the utility of 3D printed surgical devices in the context of oral and maxillofacial surgery and evaluating their efficiency. Initially, we provide an insightful overview of commonly utilized 3D printed surgical devices, discussing their innovations and clinical applications. Recognizing the pivotal role of materials, we give consideration to suitable biomaterials and printing technology of each device, while also introducing the emerging fields of regenerative scaffolds and bioprinting. Furthermore, we delve into the transformative impact of 3D printed surgical devices within specific subdivisions of oral and maxillofacial surgery, placing particular emphasis on their rejuvenating effects in bone reconstruction, orthognathic surgery, temporomandibular joint (TMJ) treatment, and other applications. Additionally, we elucidate how the integration of 3D printing technology has reshaped clinical workflows and influenced treatment outcomes in oral and maxillofacial surgery, providing updates on advancements in ensuring accuracy and cost-effectiveness in 3D printing-based procedures.

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Rehabilitation of long‐term mandibular defects by whole‐process digital fibula flap combining with implants: A case report

Cited by 3 publications

References 23 publications

Reconstruction of Segmental Mandibular Defects with Double-Barrel Fibula Flap and Osseo-Integrated Implants: A Systematic Review

Reconstruction of Segmental Mandibular Defects with Double-Barrel Fibula Flap and Osseo-Integrated Implants: A Systematic Review

Application of 3D printed titanium mesh and digital guide plate in the repair of mandibular defects using double-layer folded fibula combined with simultaneous implantation

3D printing materials and 3D printed surgical devices in oral and maxillofacial surgery: design, workflow and effectiveness

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