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Open AccessCase Report

Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note

1
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
2
Department of Oral and Maxillofacial Surgery, Kobe Central Hospital, Kobe 650-0017, Japan
3
Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
*
Author to whom correspondence should be addressed.
Dent. J. 2019, 7(3), 65; https://doi.org/10.3390/dj7030065
Received: 5 May 2019 / Revised: 12 June 2019 / Accepted: 18 June 2019 / Published: 29 June 2019
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Abstract

Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application of a polyglycolic acid (PGA) sheet is described. The implants were inserted into a viable fibula flap with severe scar contracture of the overlying epithelium resulting from vascular instability in skin paddle. Only the fibula periosteum was sutured after implant insertion; exposed surfaces were covered with a combination of PGA sheet and fibrin sealant. The area with PGA sheet coverage gradually healed with moderate contracture. The epithelium around the almost implants became immobilized. The implant-supported removable partial denture with custom titanium bar was acceptable. Dental rehabilitation is possible for reconstructed mandibles with severe scar contracture. Application of a PGA sheet may be useful for vestibuloplasty in patients with reconstructed mandibles. View Full-Text
Keywords: vestibuloplasty; polyglycolic acid sheet; skin graft; free fibula flap; custom titanium bar vestibuloplasty; polyglycolic acid sheet; skin graft; free fibula flap; custom titanium bar
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Akashi, M.; Matsumoto, K.; Takeda, D.; Yamashita, J.; Yatagai, N.; Hashikawa, K.; Komori, T. Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note. Dent. J. 2019, 7, 65.

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