[Double-barrel fibular free flap for mandibular reconstruction: beneficial alternative for dental implanted rehabilitation (5 cases)].

INTRODUCTION

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.

MATERIAL AND METHODS

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.

RESULTS

Today, dental rehabilitation has been achieved in three double-barrel fibula flaps. Details are reported concerning the implant step.

DISCUSSION

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.