Journal
BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY
Volume 58, Issue 1, Pages 62-68Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.bjoms.2019.10.310
Keywords
biomechanics; dental implant; virtual surgery; reconstruction; surgical guide
Categories
Funding
- Guangdong Provincial Science and Technology Planning Project [2015B010125002]
- National Natural Science Foundation of China [81472521, 81272951, 81072225, 81402251]
- Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology [2013163]
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Biomechanics are crucial for bony regeneration and survival of implants in functional maxillary and mandibular reconstructions. However, we know of no study that has included an analysis of biomechanics to guide the optimal position of a fibular graft in virtual surgery. This study was designed to evaluate the combination of biomechanics and accurate placement of implants for virtual surgery in reconstruction of the jaw using fibular grafts. Thirty-one patients had maxillary or mandibular reconstruction with vascularised fibular grafts and the immediate placement of dental implants. Virtual studies were made preoperatively to evaluate the biomechanics and to assess the position of the fibular grafts with minimal distribution of stress. All operations proceeded accurately and with no complications with a mean (range) of 14 (6-20) months' follow-up. According to the individual biomechanical evaluations, the optimal position for the fibular graft is probably the middle of the mandibular body or below the bottom of the maxillary sinus. The combination of biomechanical evaluation and accurate placement of dental implants is a new concept that could achieve good biomechanical positioning of fibular grafts in the jaw and a desirable level of accuracy for functional reconstruction. (C) 2019 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.
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