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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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Malocclusion Management Following Mandibular Reconstruction With Free Fibula Flaps
Jorge Ernesto Cantini Ardila1, Carlos Eduardo Torres Fuentes1, Giovanni Montealegre Gomez1
1Fundación Universitaria de Ciencias de la Salud (FUCS), Hospital San José, Bogotá, Colombia.
Craniomaxillofacial Trauma & Reconstruction
|October 28, 2021
Summary
Malocclusion is a common complication after mandibular reconstruction with free fibula flaps, often requiring orthognathic surgery. A structured approach using surgical guides and splints ensures successful correction.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
Background:
- Free fibula flaps are standard for large mandibular defect reconstruction.
- Malocclusion is a frequent complication, necessitating further orthognathic surgery.
Purpose of the Study:
- To detail demographic data, surgical techniques, and outcomes for malocclusion management post-mandibular reconstruction.
- To present a protocol for optimizing results in corrective orthognathic surgery.
Main Methods:
- Retrospective case series of patients with malocclusion after free fibula flap reconstruction.
- Preoperative planning involved imaging (X-rays, cephalometries, CT scans) for guides and splints.
- Orthognathic surgery included osteotomies and/or osteogenic distraction with miniplate or lag screw fixation.
Main Results:
- Out of 46 patients, 6 (10.9%) developed malocclusion requiring orthognathic surgery.
- Surgical interventions varied, including vertical osteotomies, bilateral sagittal split osteotomies, L-shape osteotomies, and osteogenic distraction.
- All patients achieved adequate occlusion correction with 100% consolidation at 6-month follow-up.
Conclusions:
- Malocclusion is a significant complication requiring timely identification and management.
- Corrective orthognathic surgery, guided by preoperative planning with cutting guides and occlusal splints, yields favorable and reproducible results.
