Abstract
Background The authors describe our current practice of computer-aided virtual planned and pre-executed
surgeries using microvascular free tissue transfer with immediate placement of implants
and dental prosthetics.
Methods All patients with ameloblastomas treated at New York University (NYU) Medical Center
during a 10-year period from September 2001 to December 2011 were identified. Of the
38 (36 mandible/2 maxilla) patients that were treated in this time period, 20 were
identified with advanced disease (giant ameloblastoma) requiring aggressive resection.
Reconstruction of the resultant defects utilized microvascular free tissue transfer
with an osseocutaneous fibular flap in all 20 of these patients.
Results Of the patients reconstructed with free vascularized tissue transfer, 35% (7/20)
developed complications. There were two complete flap failures with consequent contralateral
fibula flap placement. Sixteen patients to date have undergone placement of endosteal
implants for complete dental rehabilitation, nine of which received immediate placement
of the implants at the time of the free flap reconstruction. The three most recent
patients received immediate placement of dental implants at the time of microvascular
free tissue transfer as well as concurrent placement of dental prosthesis.
Conclusions To our knowledge, this patient cohort represents the largest series of comprehensive
computer aided free-flap reconstruction with dental restoration for giant type ameloblastoma.
Keywords
ameloblastoma - mandible reconstruction - free fibula
