Ruhin B, Menard P, Ceccaldi J, Dichamp J, Bertrand J-C
Service de Chirurgie Maxillo-faciale et Stomatologie, Hôpital de la Pitié Salpêtrière, Paris.
Rev Stomatol Chir Maxillofac. 2006 Nov;107(5):338-44; discussion 345-6. doi: 10.1016/s0035-1768(06)77060-7.
As major loss of mandibular bone stock requires a vascularized transfer, fibula free flap reconstruction is considered to be the best free flap for its length and reliability. Its main advantage is to accept dental implants. Single or double-barrel reconstruction can be performed. Double-barrel reconstruction is generally preferred because the bone superposition offers enough height to allow dental implants.
We reviewed five selected cases of double-barrel fibula free flap adaptive mandibular reconstruction performed among a series of 11 oral rehabilitations with planned dental implants, focusing on the technical aspects.
Today, dental rehabilitation has been achieved in three double-barrel fibula flaps. Details are reported concerning the implant step.
In this perspective, we discuss the choice of the reconstructive technique in order to obtain adequate bone height. Early in our experience and for different reasons discussed in the text, we used a single barrel fibula flap. This technique provided sufficient height in some cases, but had to be completed by bone grafts in few patients. Our experience illustrates the usefulness of the double barrel technique which provide definitive bone height sufficient for dental implants. The double-barreled technique should be considered as the best solution.
由于下颌骨大量骨量缺失需要进行带血管蒂转移，腓骨游离皮瓣重建因其长度和可靠性被认为是最佳的游离皮瓣。其主要优点是能够接受牙种植体。可进行单筒或双筒重建。一般更倾向于双筒重建，因为骨叠加提供了足够的高度以容纳牙种植体。
我们回顾了在一系列11例计划进行牙种植体植入的口腔修复病例中所进行的5例双筒腓骨游离皮瓣适应性下颌骨重建的选定病例，重点关注技术方面。
如今，3例双筒腓骨皮瓣已实现牙修复。报告了关于种植步骤的详细情况。
从这个角度出发，我们讨论为获得足够骨高度而选择重建技术的问题。在我们早期的经验中，由于文中讨论的不同原因，我们使用了单筒腓骨皮瓣。该技术在某些情况下提供了足够的高度，但少数患者还需通过骨移植来完成。我们的经验说明了双筒技术的有用性，它能提供足以进行牙种植体植入的确切骨高度。双筒技术应被视为最佳解决方案。
