CT Evaluation of Morphology of Transferred Fibula for Implant Placement in Reconstructed Mandible

Implant Dent. 2015 Oct;24(5):541-6. doi: 10.1097/ID.0000000000000290.

Abstract

Background: Dental rehabilitation with osseointegrated implants in reconstructed mandibles remains one of the most challenging procedures for oral and maxillofacial surgeons. Satisfactory outcome requires appropriate assessment of graft morphology. There are few analyses of the morphology of fibulae in reconstructed mandibles, although cadaver studies on fibular shape have been performed.

Materials and methods: In this study, we used postoperative computed tomography to retrospectively evaluate the shape, height, and orientation of fibulae transferred after mandibulectomy in 19 patients.

Results: The average height of transferred fibulae was 14.3 mm (range, 10.8-20.5 mm). The cross-sectional morphology of transferred fibulae could be classified into 2 types: apex and nonapex. The former type included knife-edged and triangular shapes; the latter included square and circular shapes.

Conclusion: When implant insertion is planned in a reconstructed mandible, the orientation of the apex of transferred fibula should be evaluated preoperatively to allow for adjustments in implant procedure because the ridge at the apex of the fibula is narrow.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Transplantation / methods*
  • Female
  • Fibula / diagnostic imaging
  • Fibula / transplantation*
  • Humans
  • Male
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Mandibular Reconstruction / methods*
  • Middle Aged
  • Tomography, X-Ray Computed