Functional and aesthetic treatment outcomes after immediate jaw reconstruction using a fibula flap and dental implants

Publication date: Available online 3 January 2019

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Sameh Attia, Joerg Wiltfang, Philipp Streckbein, Jan-Falco Wilbrand, Thaqif El Khassawna, Joerg Wiltfang, Philipp Streckbein, Hans-Peter Howaldt, Heidrun Schaaf

Summary

Purpose

Microvascular fibula flap surgery is a reliable and effective procedure for reconstructing the jaws after tumour surgery. This procedure allows the placement of dental implants after bone consolidation. This study was designed to evaluate the oral, functional, and aesthetic rehabilitation of tumour patients with immediate fibula transfer and dental implants and included assessment of diet, speech, and aesthetics.

Materials and Methods

The study included 34 patients who underwent ablative tumour surgery and immediate jaw reconstruction using a fibula free flap with consecutive rehabilitation by dental implants. In total, 134 implants were inserted into the transferred fibula. The functional and aesthetic results were assessed using a questionnaire. Implant loss and oral excursion were compared with diet type, speech ability, functionality, and patient satisfaction.

Results

Of the 34 patients included in this study, 33 completed the questionnaire. Twenty-six patients (76%) could eat normally without the limitation of a hard or soft diet, 73% could speak intelligibly, and 31 rated the aesthetic result from good to excellent.

Conclusion

The fibula flap with the early application of endosseous implants allowed primary immediate reconstruction of the jaw, significantly leading to functional and aesthetic satisfaction in patients who underwent ablative tumour surgery.

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