Morphometric study of the scapular free flap and the free rib osteomyocutaneous flap.
The scapula free flap is often the first choice for reconstruction of bony defects of the facial skeleton. However, the vascularised rib as part of a free rib osteomyocutaneous flap may be a suitable second choice. We have investigated the morphology and clinical dimensions of the 7th rib and the scapula, and the ability of the available bone to carry dental implants. The age and sex of the cadaver, and the donor side, were also recorded. The dimensions of the scapulas and 7th ribs (n=130 of each) from 65 cadavers were measured at 4 different points using osteometric methods. Examination showed that bone from the scapula and 7th rib were sufficient for placement of implants. The 7th rib gave reliable measurements for both height and width, and a consistent relation between compact and cancellous bone. Although the scapula provided adequate compact and cancellous bone, there were variations depending on the segment of bone chosen. Bones from male cadavers were more suitable for implantation. In both the scapula and the 7th rib ageing had a significant adverse effect in only one dimension. Most points of measurement have satisfactory bony dimensions for insertion of dental implants.
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany; Institute of Molecular and Cellular Anatomy, Prosection, Medical Faculty, RWTH Aachen University, Aachen, Germany. Electronic address: ttahas13@gmail.com.
Tolga Taha
TT
Sönmez
Institute of Molecular and Cellular Anatomy, Prosection, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Andreas
A
Prescher
Department of Oral and Maxillofacial Surgery, Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute, Leeds, United Kingdom.
Anastasios
A
Kanatas
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Arash
A
Zaker Shahrak
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany; Department of Oral and Maxillofacial Surgery, Heinrich-Braun-Hospital, Location Zwickau, Zwickau, Germany.
Marcus
M
Gerressen
Department of Orthopedic and Trauma Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Matthias
M
Knobe
Department of Plastic Reconstructive and Aesthetic Surgery, Medical Faculty, Süleyman Demirel University School of Medicine, Isparta, Turkey.
Selman Hakki
SH
Altuntas
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Ali
A
Modabber
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Timm Walter
TW
Steiner
Department of Oral and Maxillofacial Surgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Ralf
R
Smeets
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Alireza
A
Ghassemi
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Frank
F
Hölzle
D000886:Anthropometry / Q000379:methods; D016025:Bone Transplantation / Q000379:methods*; D002102:Cadaver; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D005260:Female; D058752:Free Tissue Flaps / Q000473:pathology* / Q000637:transplantation; D006801:Humans; D008297:Male; D064827:Myocutaneous Flap / Q000473:pathology* / Q000637:transplantation; D016348:Osseointegration / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods; D012272:Ribs / Q000033:anatomy & histology*; D012540:Scapula / Q000033:anatomy & histology*; D012737:Sex Factors; D060053:Transplant Donor Site / Q000033:anatomy & histology*
D015921:Dental Implants
Morphometric and morphological bone measurements; Oral and maxillofacial implant-carrying bone reconstruction; Rib; Scapula