title: Deep circumflex iliac artery flap with osseointegrated implants for reconstruction of mandibular benign lesions: clinical experience of 33 cases.
abstract: BACKGROUND
  A variety of free flaps have been successfully used for mandible reconstruction. The iliac crest has similar dimensions and form to the lateral mandible. The success rate and complication rate of deep circumflex iliac artery flap transplants had no significant difference to those of other microvascular bone transplants.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate our experience with the use of the vascularized free iliac flap for the reconstruction of mandibular defects following surgical resection.
  
  
  METHODS
  Data from 33 patients who underwent operations, including segmental mandibulectomy, immediate mandibular reconstruction and second-stage surgery, were retrospectively analysed. The size of segmental mandible defects ranged from 6 to 13 cm. Surgicase for cranio-maxillofacial reconstruction software was used for patients with mandible defects greater than 10 cm.
  
  
  RESULTS
  One flap loss occurred related to vascular thrombosis. The survival rate was 96.97%, and the mean follow-up was 26 months. A total of 81 osseointegrated dental implants were placed in 25 patients with adequate outcomes; 21 patients (63.64%) showed complete recovery, and in 18 out of these 21 patients, occlusion rehabilitation with fixed dentures benefitted from an appropriate distance between upper teeth and new alveolar bone. Donor-site morbidity was moderate, and most of the patients were satisfied with their functional and aesthetic results.
  
  
  CONCLUSIONS
  Our results show that deep circumflex iliac artery is a reliable method for reconstructing hemimandibular body defects with an acceptably low rate of morbidity. The iliac crest is a safe foundation for the placement of osseointegrated implants, which enable good reconstruction and further improve life quality of patients.
authors: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Medicine, College of Stomatology, Shanghai JiaoTong University, No. 639, Zhizaoju Road, Shanghai, 200011, China. qzxmed@163.com
authors: X
authors: X
authors: Qu
authors: C
authors: C
authors: Zhang
authors: W
authors: W
authors: Yang
authors: M
authors: M
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods; D015921:Dental Implants; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007085:Ilium / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery; D019930:Mandibular Prosthesis Implantation / Q000379:methods*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015921:Dental Implants