Severe Crossbite: A Sequelae For Free Fibula Flaps For Mandibular Reconstruction

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Biomaterials Science

Background:

• Free fibula flaps are increasingly favored for mandibular reconstruction due to their versatility and reliability.
• Despite surgical advancements, patients undergoing mandibular reconstruction with free fibula flaps face risks of early and late-onset complications.
• Odontogenic keratocyst (OKC) is a developmental tumor that can necessitate extensive mandibular resection.

Purpose of the Study:

• To present a case study of a patient experiencing a severe crossbite following mandibular reconstruction with a free fibula flap.
• To highlight potential complications associated with free fibula flap reconstructions in the mandible.
• To discuss the evaluation and management of malocclusion after oncologic or reconstructive surgery.

Main Methods:

• Case report of a 69-year-old male patient.
• Review of the patient's medical history, including odontogenic keratocyst (OKC) resection and free fibula flap reconstruction.
• Clinical examination for evaluation of severe crossbite and assessment of mandibular alignment.

Main Results:

• The patient presented with a severe crossbite, indicating a significant complication post-mandibular reconstruction.
• The crossbite potentially impacts masticatory function and occlusion, requiring further investigation.
• This case underscores the persistent challenges in achieving ideal functional and aesthetic outcomes after complex reconstructive procedures.

Conclusions:

• Free fibula flap reconstruction, while effective, can lead to late-onset complications such as malocclusion.
• Comprehensive post-operative evaluation is crucial for identifying and managing complications like severe crossbite.
• Further research is needed to optimize surgical techniques and post-operative care to minimize long-term complications in mandibular reconstruction.