title: Histological evaluation of microsurgical revascularized bone in the intraoral cavity: does it remain alive?
abstract: BACKGROUND
  Microsurgical revascularized fibula graft is a standard for the reconstruction of mandible or maxilla after major resection. Usually, screwed implants are inserted as a second procedure for dental rehabilitation. A lot has been published about the advantages of vascularized bone grafts, but until now there is only little information about long-term viability of inserted bone grafts.
  
  
  METHODS
  In this study, previously inserted vascularized fibula bone grafts were examined histologically. Bone biopsies were taken during dental implant insertion procedure in average of 19 months after insertion of bone grafts from 10 patients.
  
  
  RESULTS
  All bone biopsies showed partially or totally necrotic bone, although clinical examination and postoperative monitoring of the revascularized bone remained unremarkable.
  
  
  CONCLUSIONS
  The results of histological examination are surprising, due to the fact of previous insertion of a vascularized bone graft and pretended osseointegration of inserted dental implants with satisfying primary stability. Therefore, one would expect vital bone. For better understanding how much viability is really necessary for sufficient remodeling of inserted bone grafts for adequate functional load, further studies should be performed.
authors.affiliation: Department of Craniomaxillofacial Surgery, University Hospital of Zurich, Zurich, Switzerland. christine.jacobsen@usz.ch
authors.forename: Christine
authors.initials: C
authors.lastname: Jacobsen
authors.forename: Heinz-Theo
authors.initials: HT
authors.lastname: Lübbers
authors.forename: Joachim
authors.initials: J
authors.lastname: Obwegeser
authors.forename: Alex
authors.initials: A
authors.lastname: Soltermann
authors.forename: Klaus-Wilhelm
authors.initials: KW
authors.lastname: Grätz
mesh_terms: D000328:Adult; D001706:Biopsy; D016025:Bone Transplantation / Q000379:methods / Q000473:pathology*; D003758:Dental Implantation, Endosseous; D005260:Female; D005360:Fibula; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery; D008875:Middle Aged; D016896:Treatment Outcome