Successful upper alveolar reconstruction for gingival cancer using a fibular osteoadipofascial flap without osseointegrated implants.

An upper alveolar skeletal reconstruction with closure of the palatal fistula using an osteocutaneous free flap is considered an ideal reconstructive strategy after curative surgery for cancer of the lower maxilla. Although installation of osseointegrated implants into the bone has advantages for utilizing a dental prosthesis, it is often time and cost prohibitive. In the case of 1 patient, we reconstructed and fit the patient with a conventional denture, eliminating the need for installation of osseointegrated implants. The patient underwent upper alveolar reconstruction using a fibular osteoadipofascial flap, followed by a skin graft for creation of an alveololabial sulcus. It was then possible for the patient to wear a conventional denture without implants. One explanation for this success is that the regenerated mucosa on the adipofascial flap and skin graft was immobile, which allowed it to serve as a base for the dental prosthesis. The alveololabial sulcus that had been constructed kept the denture in place. This reconstruction confirmed that a fibular osteoadipofascial flap might be a useful choice in restoring a natural upper alveolar osseous and soft tissue structure.

[1]  J. Shah,et al.  Hard palate resection, microvascular reconstruction, and prosthetic restoration: A 14‐year retrospective analysis , 2003, Head & neck.

[2]  N. Futran,et al.  Midface reconstruction with the fibula free flap. , 2002, Archives of otolaryngology--head & neck surgery.

[3]  E. Genden,et al.  Iliac crest internal oblique osteomusculocutaneous free flap reconstruction of the postablative palatomaxillary defect. , 2001, Archives of otolaryngology--head & neck surgery.

[4]  F. Wei,et al.  Soft tissue management using palatal mucosa around endosteal implants in vascularized composite grafts in the mandible. , 1999, International journal of oral and maxillofacial surgery.

[5]  T. Sugihara,et al.  Functional alveolar ridge reconstruction with prefabricated iliac crest free flap and osseointegrated implants after hemimaxillectomy. , 1998, Plastic and reconstructive surgery.

[6]  G. Funk,et al.  Functional dental rehabilitation of massive palatomaxillary defects: Cases requiring free tissue transfer and osseointegrated implants , 1998, Head & neck.

[7]  M. Ueda,et al.  A comparative study of removal torque of endosseous implants in the fibula, iliac crest and scapula of cadavers: preliminary report. , 1997, Clinical oral implants research.

[8]  James S. Brown,et al.  Deep circumflex iliac artery free flap with internal oblique muscle as a new method of immediate reconstruction of maxillectomy defect , 1996, Head & neck.

[9]  M. Pogrel,et al.  Reconstruction of a complex midfacial defect with the folded fibular free flap and osseointegrated implants. , 1996, Annals of plastic surgery.

[10]  I. Mataga,et al.  Functional reconstruction of a bilateral maxillectomy defect using a fibula osteocutaneous flap with osseointegrated implants. , 1995, Plastic and reconstructive surgery.

[11]  J. Fredrickson,et al.  Fibular and iliac crest osteomuscular free flap reconstruction of the oral cavity , 1994, The Laryngoscope.

[12]  G. Funk,et al.  Osseointegrated implants: a comparative study of bone thickness in four vascularized bone flaps. , 1993, Plastic and reconstructive surgery.

[13]  S. Torii,et al.  New reconstruction for total maxillectomy defect with a fibula osteocutaneous free flap. , 1994, British journal of plastic surgery.