Vertical distraction osteogenesis of fibular free flap in mandibular prosthetic rehabilitation: a case report.
A 17-year-old boy underwent three cycles of chemotherapy and a subsequent mandibular resection for a Ewing's sarcoma of the left body and ramus. The mandible was immediately reconstructed with a microvascular osteomuscular fibular flap. One year after the mandibular reconstruction, distraction osteogenesis of the anterior portion of the fibula was performed using a Martin distractor according to the Hoffmeister technique. Bone lengthening was achieved at a rate of 1 mm/day by turning the device twice each day for 12 days. Subsequently, we waited for 70 days for bone consolidation to occur. After 6 additional weeks, five Maestro implants were placed into the distracted fibula. Bone specimens were retrieved with a trephine bur during implant placement. Mature bone was present after 70 days and after 6 months. The bone height increase was 12 mm.
Department of Maxillofacial Surgery, Bufalini Hospital, Cesena, FO, Italy.
Claudio
C
Marchetti
Marco
M
Degidi
Antonio
A
Scarano
Adriano
A
Piattelli
D000293:Adolescent; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods; D003758:Dental Implantation, Endosseous / Q000379:methods*; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery; D019857:Osteogenesis, Distraction; D012512:Sarcoma, Ewing / Q000534:rehabilitation / Q000601:surgery; D013524:Surgical Flaps; D014716:Vertical Dimension