Mandibular Reconstruction Using the Free Vascularized Fibula Graft: An Overview of Different Modifications.
Mandibular Reconstruction Using the Free Vascularized Fibula Graft: An Overview of Different Modifications.
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DOI：
10.5999/aps.2016.43.1.3
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Erdmann D
中科院分区：
文献类型：
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作者：
Kokosis G;Schmitz R;Powers DB;Erdmann D
下颌骨的重建是一个复杂的过程，因为必须解决各种美容和功能挑战，包括咀嚼和口腔能力。许多外科技术已经被描述来解决这些挑战，包括非血管化骨移植、血管化骨移植和与组织工程相关的方法。本文综述了游离带血管腓骨移植物的不同改良方法，自1989年Hidalgo引入以来，游离带血管腓骨移植物已成为下颌骨重建的首选。腓骨游离皮瓣可以根据具体重建的需要进行各种修改。骨皮瓣可用于复合缺损的重建。例如，腓骨的“双管”可以增强美观和功能效果，以及立即进行一期骨整合牙种植。最近描述的术前虚拟手术计划，以促进新颌骨重塑，可以保证良好的效果。综上所述，游离腓骨移植物是目前复合（内外）口腔缺损下颌骨重建的“金标准”，也是实现一期种植的一种方式。
The reconstruction of the mandible is a complex procedure because various cosmetic as well as functional challenges must be addressed, including mastication and oral competence. Many surgical techniques have been described to address these challenges, including non-vascularized bone grafts, vascularized bone grafts, and approaches related to tissue engineering. This review summarizes different modifications of the free vascularized fibula graft, which, since its introduction by Hidalgo in 1989, has become the first option for mandibular reconstruction. The fibula free flap can undergo various modifications according to the individual requirements of a particular reconstruction. Osteocutaneous flaps can be harvested for reconstruction of composite defects. 'Double-barreling' of the fibula can, for instance, enable enhanced aesthetic and functional results, as well as immediate one-stage osseointegrated dental implantation. Recently described preoperative virtual surgery planning to facilitate neomandible remodeling could guarantee good results. To conclude, the free fibula bone graft can currently be regarded as the "gold standard" for mandibular reconstruction in case of composite (inside and outside) oral cavity defects as well as a way of enabling the performance of one-stage dental implantation.