A Comparison of Bone Resorption Over Time : An Analysis of the Free Scapular, Iliac Crest, and Fibular Microvascular Flaps in Mandibular Reconstruction

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Wilkman , T , Apajalahti , S , Wilkman , E , Törnwall , J & Lassus , P 2017 , ' A Comparison of Bone Resorption Over Time : An Analysis of the Free Scapular, Iliac Crest, and Fibular Microvascular Flaps in Mandibular Reconstruction ' , Journal of Oral and Maxillofacial Surgery , vol. 75 , no. 3 , pp. 616-621 . https://doi.org/10.1016/j.joms.2016.09.009

Title: A Comparison of Bone Resorption Over Time : An Analysis of the Free Scapular, Iliac Crest, and Fibular Microvascular Flaps in Mandibular Reconstruction
Author: Wilkman, Tommy; Apajalahti, Satu; Wilkman, Erika; Törnwall, Jyrki; Lassus, Patrik
Contributor: University of Helsinki, Oral and Maxillofacial Surgery
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, HUS Musculoskeletal and Plastic Surgery
Date: 2017-03
Language: eng
Number of pages: 6
Belongs to series: Journal of Oral and Maxillofacial Surgery
ISSN: 0278-2391
URI: http://hdl.handle.net/10138/236749
Abstract: Purpose: The aim of the present study was to compare the resorption of the bone in the free scapular, free iliac crest, and free fibular microvascular flaps in mandibular reconstruction over time. Patients and Methods: In the present retrospective study, we analyzed 186 consecutive patients with scapular, fibular, or deep circumflex iliac artery (DCIA) osseous free microvascular flaps in mandibular reconstruction. We followed up the patients clinically and using multislice computed tomography (MSCT) with volume analyses of the bone. The volume of the bone was analyzed against time. Results: A total of 38 patients fulfilled the study criteria. Resorption of the osseous flaps was found to continue for several years. At 2 years, the volume loss was 14% for the scapula, 3% for the DCIA, and 1% for the fibula. Three-dimensional (3D) volume analysis of the MSCT scans showed more resorption than 2-dimensional analyses of the radiographs. Postoperative radiation therapy, patient age, and patient gender did not correlate with bone resorption. Conclusions: After microvascular mandibular reconstruction, the volume reduction over time is the least in the fibula and the greatest in scapula, with that of the DCIA in between. The volume reduction continues for several years in all of these. For assessment of the volume reduction of osseal reconstruction, a 3D volume analysis is more reliable than height by width measurements. (C) 2016 American Association of Oral and Maxillofacial Surgeons
Subject: LONG-TERM EVALUATION
NECK RECONSTRUCTION
GRAFTS
HEIGHT
HEAD
MASS
313 Dentistry
3126 Surgery, anesthesiology, intensive care, radiology
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