title: Successful upper alveolar reconstruction for gingival cancer using a fibular osteoadipofascial flap without osseointegrated implants.
abstract: An upper alveolar skeletal reconstruction with closure of the palatal fistula using an osteocutaneous free flap is considered an ideal reconstructive strategy after curative surgery for cancer of the lower maxilla. Although installation of osseointegrated implants into the bone has advantages for utilizing a dental prosthesis, it is often time and cost prohibitive. In the case of 1 patient, we reconstructed and fit the patient with a conventional denture, eliminating the need for installation of osseointegrated implants. The patient underwent upper alveolar reconstruction using a fibular osteoadipofascial flap, followed by a skin graft for creation of an alveololabial sulcus. It was then possible for the patient to wear a conventional denture without implants. One explanation for this success is that the regenerated mucosa on the adipofascial flap and skin graft was immobile, which allowed it to serve as a base for the dental prosthesis. The alveololabial sulcus that had been constructed kept the denture in place. This reconstruction confirmed that a fibular osteoadipofascial flap might be a useful choice in restoring a natural upper alveolar osseous and soft tissue structure.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tottori University Faculty of Medicine, Yonago, Japan. binnakay@naa.att.ne.jp
authors.forename: Bin
authors.initials: B
authors.lastname: Nakayama
authors.forename: Hyodo
authors.initials: H
authors.lastname: Ikuo
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kamei
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hachiya
authors.forename: Shuhei
authors.initials: S
authors.lastname: Torii
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000539:Alveolar Process / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005887:Gingival Neoplasms / Q000601:surgery*; D006801:Humans; D019931:Maxillofacial Prosthesis Implantation; D008875:Middle Aged; D009367:Neoplasm Staging; D016348:Osseointegration / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps