Primary and secondary reconstruction of mandibular discontinuity defects with vascularized flap is currently the standard of care in many institutions. The most commonly used donor site for such flaps is fibula. Fibula provides enough bone length, allows 2-team approach, and has low donor site morbidity and abundant periosteal blood supply. The placement of endosseous implants in the vascularized fibula flap also facilitates functional dental rehabilitation. This clinical report describes the prosthetic rehabilitation and the complications of 2 mandibular discontinuity defects treated with vascularized fibula flap and implant-supported fixed prosthesis.Abstract

Figure 1. Case 1 osteoradionecrosis of the mandible. Figure 2. Case 1 osseointegrated implants and abutment connection. Figure 3. Case 1 final prosthesis in occlusion. Figure 4. Case 1 implant alignment.

Figure 5. Case 2 panoramic radiograph prior to implant placement. Figure 6. Case 2 osseointegrated implants and abutment connection. Figure 7. Case 2 abutment connection.

Figure 8. Case 2 occlusal view of the final prosthesis. Figure 9. Case 2 final prosthesis in occlusion.
Contributor Notes
Presented at the joint meeting of the International Society for Maxillofacial Rehabilitation and the American Academy of Maxillofacial Prosthetics, Maui, Hawaii, October 12–15, 2006.