Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Dental Implantology

Background:

• Free fibula flap is the standard for mandibular reconstruction.
• Subscapular system flaps are an alternative when fibula flaps are not feasible.
• Oromandibular reconstruction requires careful consideration for future dental rehabilitation.

Purpose of the Study:

• To evaluate the possibility of dental implant placement in patients who underwent oromandibular reconstruction using a scapular free flap.
• To assess bone stock and density changes in the scapular free flap over time.

Main Methods:

• Retrospective review of 10 patients who received a lateral border of the scapula free flap for mandible reconstruction.
• Measurement of cortical and cancellous bone density in Hounsfield units (HU).
• Analysis of changes in bone density, height, and width using statistical tests.

Main Results:

• Dental implantation was performed in 50% of patients.
• All patients possessed adequate bone stock for potential dental implants.
• Significant reduction in bone height and width (P < 0.001) was observed.
• Significant increase in both cortical (P < 0.001) and cancellous (P = 0.004) bone density.

Conclusions:

• Scapular free flaps provide a viable option for oromandibular reconstruction with potential for dental implant placement.
• Bone dimensions decrease post-reconstruction, but bone density increases, which may support implant osseointegration.