title: Value of the preservation of an osseous mandibular rim with a fibula free flap reconstruction.
abstract: BACKGROUND
  Reconstruction of the mandible with microvascularized fibula transplants is actually a well-established procedure, yet the major component is the limited diameter of the diaphysis that can induce oral rehabilitation's failure, especially in dentate patients. In this paper, we report our surgical procedure allowing preservation of the mandibular height. The primary objective was to assess aesthetic and functional improvements of preservation of an osseous mandibular rim with a fibula free flap reconstruction.
  
  
  METHODS
  Five patients (all males, mean age of 60 years) were treated with this method. Aetiologies were tumour in 3 cases, and osteoradionecrosis in the two others cases. We described all step of our surgical procedure and the functional, aesthetic and carcinologic results were evaluated. The follow up varies from 6 to 30 months.
  
  
  RESULTS
  One patient died at 12 days from unrelated affection. For the other patients, both the aesthetics and functional outcomes were better than in case of mandibular interruption surgery. In fact, the mandibular contour of the mandibule was preserved and the height of mandible was restored. One patient is in progress of dental rehabilitation with osseous implants. Carcinologically, no local recurrence was observed.
  
  
  CONCLUSIONS
  This technique is reliable and enables to optimize oral rehabilitation with endosteal implants. Nevertheless, we consider that the 3D scanner is essential before the intervention to evaluate the osseous reach. Moreover, if necessarily the procedure can be modified intraoperatively.
authors.forename: S
authors.initials: S
authors.lastname: Cortese
authors.forename: B
authors.initials: B
authors.lastname: Phulpin
authors.forename: R
authors.initials: R
authors.lastname: Mastronicola
authors.forename: P
authors.initials: P
authors.lastname: Gangloff
authors.forename: J
authors.initials: J
authors.lastname: Guillet
authors.forename: M
authors.initials: M
authors.lastname: Roch
authors.forename: L
authors.initials: L
authors.lastname: Julien
authors.forename: J L
authors.initials: JL
authors.lastname: Verhaeghe
authors.forename: G
authors.initials: G
authors.lastname: Dolivet
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged