ABSTRACT
Defects requiring reconstruction in the mandible are commonly encountered and may
result from resection of benign or malignant lesions, trauma, or osteoradionecrosis.
Mandibular defects can be classified according to location and extent, as well as
involvement of mucosa, skin, and tongue. Vascularized bone flaps, in general, provide
the best functional and aesthetic outcome, with the fibula flap remaining the gold
standard for mandible reconstruction. In this review, we discuss classification and
approach to reconstruction of mandibular defects. We also elaborate upon four commonly
used free osteocutaneous flaps, inclusive of fibula, iliac crest, scapula, and radial
forearm. Finally, we discuss indications and use of osseointegrated implants as well
as recent advances in mandibular reconstruction.
KEYWORDS
Bone flap - condyle - fibular flap - mandible - osseointegrated implant - osteocutaneous
flap
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Christopher J SalgadoM.D.
Division of Plastic Surgery, Department of Surgery, University of Miami Miller School
of Medicine
Holtz Children's Center – ET3019, 1611 NW 12th Avenue, Miami, FL 33136
Email: salgado_plastics@hotmail.com