Vascularized parietal bone flaps. A new dimension in mandibular reconstruction.

The ultimate objective, when treating a mandibular defect, is to restore completely the function and cosmetic appearance of the face. The reconstruction must include bone from a similar source, good in quality and shape and living, to resist infection and the continuous stress that takes place in the mandible during mastication. Our technique for mandibular reconstruction using bone from the calvarium, of full thickness to receive implants and living because it is pedicled on the galea (from the superficial temporal artery) is reported. Our criteria for reconstruction, and the analysis of all the cases reconstructed with the technique mentioned above, is presented. Emphasis is placed on the good shape of this bone flap, its vascularization studies (compared with those in other techniques) and the high rate of success in both cosmetic and functional results.