-
All Events
IAO-EAO-SIdP joint meeting 2024EAO-DGI joint meeting 202329th Annual Scientific CongressEAO Digital Days 2021EAO Digital Days 202028th Annual Scientific Congress27th Annual Scientific Congress26th Annual Scientific Congress25th Annual Scientific Congress24th Annual Scientific Congress23rd Annual Scientific Congress -
All Content TypesAbstractArticle ReviewePosterLearning moduleLearning QuizMatching SlidePDF DocumentWebcast
-
Sort ByRelevance
Background:
The preferred choice for reconstructing most segmental mandibular defects is the fibula osteoseptocutaneous free flap. However, the anterior mandibular cross-sectional height is approximately twice that of the fibula, which needs addressing when restoring both aesthetic facial height and alveolar ridge height for dental rehabilitation. Double-barreling the fibula increases its height whilst leaving the upper strut architecturally unchanged for accepting osseointegrated dental implants (ODIs) primarily or secondarily. Alternatively, vertical distraction osteogenesis (VDO) can increase the height of a single-barreled fibula inset at the inferior mandibular margin but the process alters internal bony architecture. ODIs are placed secondarily once alveolar ridge height has been restored.
Aim/Hypothesis:
Whilst both techniques increase construct height, it is unknown whether one provides better quality osseointegration outcomes. Accordingly, we evaluated and compared osseointegration quality for each method. We also report the complications and our solutions.
Material and Methods:
Between 2003 and 2009, all patients who underwent parasymphyseal/symphyseal segmental mandibular defect reconstruction using vertical distraction osteogenesis (VDO) of single-barreled fibula with secondary osseointegration (Group A: 10 patients, 35 ODIs) or double-barreled fibula with primary osseointegration (Group B: 13 patients, 36 ODIs) were prospectively evaluated for crown-implant ratios (CIRs), mesial/distal marginal bone losses (MBLs) and complications. Within Group B, 18 ODIs were surrounded by palatal mucosal grafts (PMGs); the other 18 retained fibula skin paddle.
Results:
PMGs in Group B improved mesial (p<0.001) and distal (p<0.001) MBLs. Mesial MBL of Group B ODIs with PMGs was better than Group A ODIs (p<0.05), despite higher CIRs in Group A (p<0.01). Mesial (p<0.01) and distal (p<0.05) MBLs of Group A ODIs were better than Group B ODIs without PMGs. Complications in Group A were common and complex, unlike Group B. All patients completed dental rehabilitation.
Conclusions and clinical implications:
Osseointegration was adequate to complete dental rehabilitation in Group B without PMGs, but was significantly better in Group A, and significantly best in Group B with PMGs. Given the complexity and frequency of complications in Group A, we recommend the double-barrel configuration with ODIs for dentulous anterior segmental mandibular defect reconstruction. PMGs have a definite advantage and should be utilized whenever possible.
Background:
The preferred choice for reconstructing most segmental mandibular defects is the fibula osteoseptocutaneous free flap. However, the anterior mandibular cross-sectional height is approximately twice that of the fibula, which needs addressing when restoring both aesthetic facial height and alveolar ridge height for dental rehabilitation. Double-barreling the fibula increases its height whilst leaving the upper strut architecturally unchanged for accepting osseointegrated dental implants (ODIs) primarily or secondarily. Alternatively, vertical distraction osteogenesis (VDO) can increase the height of a single-barreled fibula inset at the inferior mandibular margin but the process alters internal bony architecture. ODIs are placed secondarily once alveolar ridge height has been restored.
Aim/Hypothesis:
Whilst both techniques increase construct height, it is unknown whether one provides better quality osseointegration outcomes. Accordingly, we evaluated and compared osseointegration quality for each method. We also report the complications and our solutions.
Material and Methods:
Between 2003 and 2009, all patients who underwent parasymphyseal/symphyseal segmental mandibular defect reconstruction using vertical distraction osteogenesis (VDO) of single-barreled fibula with secondary osseointegration (Group A: 10 patients, 35 ODIs) or double-barreled fibula with primary osseointegration (Group B: 13 patients, 36 ODIs) were prospectively evaluated for crown-implant ratios (CIRs), mesial/distal marginal bone losses (MBLs) and complications. Within Group B, 18 ODIs were surrounded by palatal mucosal grafts (PMGs); the other 18 retained fibula skin paddle.
Results:
PMGs in Group B improved mesial (p<0.001) and distal (p<0.001) MBLs. Mesial MBL of Group B ODIs with PMGs was better than Group A ODIs (p<0.05), despite higher CIRs in Group A (p<0.01). Mesial (p<0.01) and distal (p<0.05) MBLs of Group A ODIs were better than Group B ODIs without PMGs. Complications in Group A were common and complex, unlike Group B. All patients completed dental rehabilitation.
Conclusions and clinical implications:
Osseointegration was adequate to complete dental rehabilitation in Group B without PMGs, but was significantly better in Group A, and significantly best in Group B with PMGs. Given the complexity and frequency of complications in Group A, we recommend the double-barrel configuration with ODIs for dentulous anterior segmental mandibular defect reconstruction. PMGs have a definite advantage and should be utilized whenever possible.
Background:
The preferred choice for reconstructing most segmental mandibular defects is the fibula osteoseptocutaneous free flap. However, the anterior mandibular cross-sectional height is approximately twice that of the fibula, which needs addressing when restoring both aesthetic facial height and alveolar ridge height for dental rehabilitation. Double-barreling the fibula increases its height whilst leaving the upper strut architecturally unchanged for accepting osseointegrated dental implants (ODIs) primarily or secondarily. Alternatively, vertical distraction osteogenesis (VDO) can increase the height of a single-barreled fibula inset at the inferior mandibular margin but the process alters internal bony architecture. ODIs are placed secondarily once alveolar ridge height has been restored.
Aim/Hypothesis:
Whilst both techniques increase construct height, it is unknown whether one provides better quality osseointegration outcomes. Accordingly, we evaluated and compared osseointegration quality for each method. We also report the complications and our solutions.
Material and Methods:
Between 2003 and 2009, all patients who underwent parasymphyseal/symphyseal segmental mandibular defect reconstruction using vertical distraction osteogenesis (VDO) of single-barreled fibula with secondary osseointegration (Group A: 10 patients, 35 ODIs) or double-barreled fibula with primary osseointegration (Group B: 13 patients, 36 ODIs) were prospectively evaluated for crown-implant ratios (CIRs), mesial/distal marginal bone losses (MBLs) and complications. Within Group B, 18 ODIs were surrounded by palatal mucosal grafts (PMGs); the other 18 retained fibula skin paddle.
Results:
PMGs in Group B improved mesial (p<0.001) and distal (p<0.001) MBLs. Mesial MBL of Group B ODIs with PMGs was better than Group A ODIs (p<0.05), despite higher CIRs in Group A (p<0.01). Mesial (p<0.01) and distal (p<0.05) MBLs of Group A ODIs were better than Group B ODIs without PMGs. Complications in Group A were common and complex, unlike Group B. All patients completed dental rehabilitation.
Conclusions and clinical implications:
Osseointegration was adequate to complete dental rehabilitation in Group B without PMGs, but was significantly better in Group A, and significantly best in Group B with PMGs. Given the complexity and frequency of complications in Group A, we recommend the double-barrel configuration with ODIs for dentulous anterior segmental mandibular defect reconstruction. PMGs have a definite advantage and should be utilized whenever possible.
Background:
The preferred choice for reconstructing most segmental mandibular defects is the fibula osteoseptocutaneous free flap. However, the anterior mandibular cross-sectional height is approximately twice that of the fibula, which needs addressing when restoring both aesthetic facial height and alveolar ridge height for dental rehabilitation. Double-barreling the fibula increases its height whilst leaving the upper strut architecturally unchanged for accepting osseointegrated dental implants (ODIs) primarily or secondarily. Alternatively, vertical distraction osteogenesis (VDO) can increase the height of a single-barreled fibula inset at the inferior mandibular margin but the process alters internal bony architecture. ODIs are placed secondarily once alveolar ridge height has been restored.
Aim/Hypothesis:
Whilst both techniques increase construct height, it is unknown whether one provides better quality osseointegration outcomes. Accordingly, we evaluated and compared osseointegration quality for each method. We also report the complications and our solutions.
Material and Methods:
Between 2003 and 2009, all patients who underwent parasymphyseal/symphyseal segmental mandibular defect reconstruction using vertical distraction osteogenesis (VDO) of single-barreled fibula with secondary osseointegration (Group A: 10 patients, 35 ODIs) or double-barreled fibula with primary osseointegration (Group B: 13 patients, 36 ODIs) were prospectively evaluated for crown-implant ratios (CIRs), mesial/distal marginal bone losses (MBLs) and complications. Within Group B, 18 ODIs were surrounded by palatal mucosal grafts (PMGs); the other 18 retained fibula skin paddle.
Results:
PMGs in Group B improved mesial (p<0.001) and distal (p<0.001) MBLs. Mesial MBL of Group B ODIs with PMGs was better than Group A ODIs (p<0.05), despite higher CIRs in Group A (p<0.01). Mesial (p<0.01) and distal (p<0.05) MBLs of Group A ODIs were better than Group B ODIs without PMGs. Complications in Group A were common and complex, unlike Group B. All patients completed dental rehabilitation.
Conclusions and clinical implications:
Osseointegration was adequate to complete dental rehabilitation in Group B without PMGs, but was significantly better in Group A, and significantly best in Group B with PMGs. Given the complexity and frequency of complications in Group A, we recommend the double-barrel configuration with ODIs for dentulous anterior segmental mandibular defect reconstruction. PMGs have a definite advantage and should be utilized whenever possible.