Related Experiment Video
Updated: Mar 9, 2026
10:42
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
7.1K
Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years
J S Brown1, D Lowe2, A Kanatas3
1Aintree University Hospital and Warrington Hospital, Liverpool University, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool L9 1AE, United Kingdom.
The British Journal of Oral & Maxillofacial Surgery
|January 10, 2017
Summary
This review of mandibular reconstruction techniques found the iliac crest flap had a higher failure rate than fibular, radial, and scapular flaps. Comprehensive outcome reporting is needed for comparing flap techniques.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Mandibular defects require complex reconstruction.
- Composite free flaps are commonly used for mandibular reconstruction.
- Varied outcomes exist across different flap techniques.
Purpose of the Study:
- To systematically review techniques and outcomes of composite free flaps for mandibular reconstruction.
- To compare the failure rates and complication profiles of different flap types.
- To identify areas for improvement in reporting reconstructive surgery outcomes.
Main Methods:
- Systematic review of studies published between 1990 and 2015.
- Analysis of 9499 mandibular reconstructions using various composite free flaps.
- Evaluation of flap failure rates, osteotomy, non-union, and fistula rates.
Main Results:
- Fibular, radial, and scapular flaps had a combined failure rate of 3.4%, significantly lower than the iliac crest flap (6.2%).
- Implant-retained prostheses were more frequently used after iliac crest flap reconstruction.
- Reporting of osteotomy, non-union, and fistula rates was inconsistent across studies.
Conclusions:
- While significant differences in flap failure exist, fundamental outcome reporting requires standardization.
- Fibular, radial, and scapular flaps appear to offer lower failure rates compared to iliac crest flaps.
- Future research should focus on consistent and comprehensive outcome reporting for mandibular reconstruction techniques.
