Iliac crest towards alveolar processes or mandibular inferior margin in mandibular reconstruction with a vascularized iliac bone flap: which is better?

Clin Oral Investig

Department of Oral and Maxillofacial Surgery, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Peking University School and Hospital of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.

Published: February 2023

AI Article Synopsis

  • The study compares two techniques for using iliac bone flaps in reconstructing mandibular defects, focusing on different orientations of the iliac crest.
  • Data was collected from 78 patients, dividing them into two groups based on the orientation of the iliac crest during surgery.
  • Results showed that the group with the iliac crest towards the alveolar process had better outcomes in bone symmetry, width, intermaxillary distance, and cortical thickness, suggesting it may be a more effective method for mandible reconstruction.

Article Abstract

Objective: The study aims to compare differences among iliac bone flaps with different iliac crest orientations for the repair of mandibular defects with an aim to analyze their advantages, disadvantages, and effects.

Material And Methods: Clinical data and computed tomography scans of all patients who underwent iliac bone flap repair of the mandible in Peking University School and Hospital of Stomatology from January 2016 to April 2021 were collected. Patients were divided into the iliac crest towards alveolar process (Group A) and the iliac crest towards mandibular inferior margin (Group B). Software was used to measure corresponding indicators. The results obtained for the groups were statistically analyzed.

Results: The study included 78 patients (25 and 53 in groups A and B, respectively). The symmetry of the LC-type defect was better in group A (p < 0.05). The all-bone width of the alveolar process side in group A was greater than 6 mm; in 15 cases of group B, the width was less than 6 mm (p < 0.05). The intermaxillary distance of two sites were higher in group B (p < 0.05). The bone cortical thickness was significantly thicker in group A (p < 0.05).

Conclusion: One year after the mandibular body defect was reconstructed with a vascularized iliac bone flap, the iliac crest towards alveolar process group showed better bone symmetry, width, intermaxillary distance, and cortical thickness to meet the planting requirements.

Clinical Relevance: The use of an iliac crest towards alveolar process may be a better approach for mandible reconstruction.

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Source
http://dx.doi.org/10.1007/s00784-022-04823-0DOI Listing

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