ORIGINAL ARTICLE   

Minerva Dental and Oral Science 2022 June;71(3):139-48

DOI: 10.23736/S2724-6329.21.04597-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Reconstruction of the mandibular symphysis: pilot study compares three different flaps

Giorgio BARBERA ✉, Marco DELLA MONACA, Luigi MANGANIELLO, Andrea BATTISTI, Paolo PRIORE, Andrea CASSONI, Valentina TERENZI, Valentino VALENTINI

Department of Oncological and Reconstructive Maxillo-Facial Surgery, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy

BACKGROUND: Restoration of mandibular continuity, functionality and attempting to return to the patient’s premorbid state is the ultimate goal of reconstruction. Some studies compare different flaps, but the reconstructed portions vary and there is little consensus on the best option for a particular defect.
METHODS: This pilot study compares three different reconstructive options with free flaps. We will analyze the accuracy of the reconstruction, the postoperative complications related to the reconstruction, the morbidity of the donor site. This pilot study compares three different reconstructive options with free flap in the reconstruction of the mandibular symphysis: iliac crest, scapula and fibula.
RESULTS: In our sample the morbidity of the donor site was overlapping, as for all three choices free from complications. In post resection edentulous patients, the fibula seems to guarantee better positioning, while in patients with residual occlusion the iliac crest seems to allow a more congruous repositioning. The fibula seems to have a superiority over the other flaps in terms of accuracy in all types of patients.
CONCLUSIONS: Contrary to the most recent work on the accuracy of CAD/CAM, we have analyzed the error in the reconstruction of a specific segment and in the repositioning of the residual mandibular component without the use of guided computer programming.

KEY WORDS: Reconstructive surgical procedures; Free tissue flaps; Fibula; Ilium; Scapula