2014 Volume 40 Issue 4 Pages 426-431
Free vascularized fibula flaps are commonly used for mandibular reconstruction. However, when performing mandibular reconstruction using such flaps, it is necessary to consider the patient's general condition or tumor prognosis. From September 2009 to November 2013, mandibular reconstruction was performed on 25 patients in the Division of Dentistry, Department of Oral and Maxillofacial Surgery, Yamagata University Hospital. In all, immediate mandibular reconstruction was performed using reconstruction plates (RP) on 13 patients with benign tumors. Seven of these 13 patients underwent secondary mandibular reconstruction using autogenous bone grafting. In patients with malignant tumors (11 immediate mandibular reconstructions and 1 secondary case), free vascularized fibula flaps were used for 4 patients, rectus abdominis myocutaneous flaps (RAMC) with RP were used for 3 patients, RAMC without RP were used for 2 patients, an anterolateral thigh flap with RP was used for 1 patient, and a forearm flap with RP was used for 1 patient. A titanium mesh tray and iliac particulate cancellous bone and marrow were used in the secondary case. To improve postoperative masticatory function, 9 out of the 25 patients underwent dental implant placement in the reconstructed area. Two patients who completed prosthetic treatment with implant overdentures showed considerable improvement in occlusal function.For patients requiring mandibular reconstruction, a comprehensive treatment strategy that considers not only facial contours but also occlusal rehabilitation is indispensable for improving quality of life.
