title: Esthetic and functional reconstruction of the posttumoral interrupted mandible with double-barrel fibular free flap graft: rationale for a microsurgical and prosthodontic approach.
abstract: Reconstruction after substantial osseous, cutaneous, and muscular tissue loss following a mandibular resection is a challenge. The use of a fibular free flap is an outstanding, but delicate, treatment option. These grafts, using the double-barrel technique, can achieve an almost complete reconstruction of the mandibular defect. The challenge posed by these treatments is to achieve an end result that is both functional and esthetically pleasing-an endeavor that requires a defined prosthetic plan prior to complete microsurgical reconstruction. Using a detailed clinical case, this article discusses the importance of planning the mandible reconstruction with double-barrel fibular graft in view of an implant-supported fixed partial denture. Immediate implant loading was even possible in this case. This approach allows improvement of the final esthetic and functional result of such a complex rehabilitation. Maxillofacial reconstructive surgery should seek to establish a near-as-normal anatomic situation that will allow a permanent implant rehabilitation that is both esthetic and durable.
authors: Implantology Department, National Institution of the Invalides, Paris, France. LoB5@mac.com
authors: Armand-Régis
authors: AR
authors: Paranque
authors: Marc
authors: M
authors: Steve
authors: Lydia
authors: L
authors: Vazquez
authors: Alain
authors: A
authors: Bolleyn
authors: Marie-Andrée
authors: MA
authors: Roze-Pellat
authors: David M
authors: DM
authors: Dohan Ehrenfest
mesh_terms: D000564:Ameloblastoma / Q000534:rehabilitation / Q000601:surgery*; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous; D019094:Dental Prosthesis, Implant-Supported; D003830:Denture, Partial, Fixed; D005360:Fibula / Q000601:surgery / Q000637:transplantation; D058752:Free Tissue Flaps; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D008866:Microsurgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019651:Plastic Surgery Procedures / Q000379:methods*