Precise Reconstruction of Mandibular Angle Defects Using Digital Technology-Assisted Vascularized Iliac Crest Flap...

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Biomaterials Science

Background:

• Mandibular angle reconstruction using fibula and iliac crest flaps is common.
• Accurate restoration of the mandibular angle with iliac flaps can be challenging, potentially impacting aesthetics.

Purpose of the Study:

• To compare mandibular angle contour, donor-site function, and quality of life.
• To evaluate digitally assisted mandibular angle reconstruction techniques.
• To compare pedicled iliac crest flaps alone versus combined vascularized and nonvascularized iliac bone grafts.

Main Methods:

• Retrospective cohort study of 17 patients undergoing mandibular angle reconstruction.
• Two groups: pedicled deep circumflex iliac artery (DCIA) flap alone vs. DCIA flap with nonvascularized iliac bone graft (NVIBG).
• Outcome variables included 3D mandibular measurements, bone resorption, donor-site function (Harris Hip Score), and quality of life (EORTC QLQ-H&N35).

Main Results:

• The DCIA + NVIBG group showed significantly smaller discrepancies in mandibular angle contour compared to the DCIA-alone group (P < .01).
• Bone resorption rates ranged from 13.37% to 18.85%.
• No significant differences were observed in hospitalization costs, operative time, donor-site function, or quality of life between groups (P > .05).

Conclusions:

• Combining vascularized and nonvascularized iliac bone grafts is superior for mandibular angle contour restoration.
• This combined technique achieves improved aesthetic outcomes without increasing postoperative complications.
• The combined approach does not adversely affect donor-site function or patient quality of life.