Mandibular Rehabilitation with Fibula Free Flap and Dental Implant
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A 21-year-old male with a plexiform-type ameloblastoma in the left mandible underwent decompression, partial mandibulectomy, and reconstruction using a fibula free flap. Virtual surgical planning facilitated precise resection and optimal placement of the fibula graft at the mid-height of the mandible, thereby improving the crown-to-implant ratio. The temporomandibular joint (TMJ) disc was preserved during mandibulectomy to prevent ankylosis and support functional remodeling of the neo-condyle. Postoperatively, malocclusion was managed through intermaxillary fixation, and implant rehabilitation was initiated after a 9-month healing period. At the 55-month follow-up, the patient exhibited stable occlusion, restored mouth opening, and absence of recurrence or complications at the reconstruction or implant sites. The neo-condyle demonstrated rounded contours resembling a natural condyle, and implant osseointegration was achieved without prosthetic complications. This case elucidates the significance of precise fibula flap positioning at the mid-height of the mandible to ensure long-term implant stability. Additionally, it highlights the pivotal role of TMJ disc preservation in facilitating functional recovery.
Abstract
A 21-year-old male with a plexiform-type ameloblastoma in the left mandible underwent decompression, partial mandibulectomy, and reconstruction using a fibula free flap. Virtual surgical planning facilitated precise resection and optimal placement of the fibula graft at the mid-height of the mandible, thereby improving the crown-to-implant ratio. The temporomandibular joint (TMJ) disc was preserved during mandibulectomy to prevent ankylosis and support functional remodeling of the neo-condyle. Postoperatively, malocclusion was managed through intermaxillary fixation, and implant rehabilitation was initiated after a 9-month healing period. At the 55-month follow-up, the patient exhibited stable occlusion, restored mouth opening, and absence of recurrence or complications at the reconstruction or implant sites. The neo-condyle demonstrated rounded contours resembling a natural condyle, and implant osseointegration was achieved without prosthetic complications. This case elucidates the significance of precise fibula flap positioning at the mid-height of the mandible to ensure long-term implant stability. Additionally, it highlights the pivotal role of TMJ disc preservation in facilitating functional recovery.
참고문헌 (19)
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