RT Journal Article
T1 Primary Maxillary Reconstruction With Fibula Flap and Dental Implants: A Comparative Study Between Virtual Surgical Planning and Standard Surgery in Class IIC Defects
A1 Navarro Cuéllar, Carlos
A1 Bullejos Martínez, Elena
A1 Navarro Cuéllar, Ignacio
A1 López López, Ana María
A1 Tousidonis Rial, Manuel
A1 Sánchez Pérez, Arturo
A1 Salmerón Escobar, José Ignacio
AB PurposeOncological patients who undergo bilateral subtotal maxillectomies develop functional and esthetic sequelae that require immediate reconstruction. The purpose of this study is to evaluate the primary reconstruction of maxillary defects with fibula flap and dental implants assisted by virtual surgical planning (VSP) and to assess the postoperative outcomes compared with standard surgery.Material and MethodsA retrospective study was designed between January 2016 and April 2020 with 12 oncologic patients who underwent subtotal bilateral maxillectomy. Six consecutive patients were treated by standard surgical procedure (SS) at the beginning of the study. In 2018, the VSP was implemented, and 6 consecutive patients were treated using this technique. All patients were rehabilitated with Ticare implants and implant prostheses. Anatomic position of the bone, bone apposition, change of vertical distance, and horizontal shift, the operative and ischemia time, the esthetic results, and the functional rehabilitation were evaluated and compared.ResultsThe position of the bone in anatomical position was 100% in the VSP group vs 66% in the SS group. The bone apposition was 100% in the VSP group vs 83.3%. The change of vertical distance and the horizontal shift were lower in the VSP group (P < .05). The ischemia time and operative time were shorter in the VSP group (P < .05). A good esthetic result was achieved in 83.3% in the VSP group vs 33.3% in the SS group; 81 dental implants and 1 zygomatic implant were placed. The success rate was 95% in the VSP group and 92.6% in the SS group. All patients were rehabilitated with implant prosthesis.ConclusionsVSP improves the accuracy of midface reconstruction (class IIC defect) with a better anatomical position of the bone, a higher rate of bone contact, and a lower change in vertical distance compared with standard surgery. It significantly improves the esthetic result, reduces ischemia time, and operation time.
PB Elsevier
SN 0278-2391
YR 2021
FD 2021-01-01
LK https://hdl.handle.net/20.500.14352/107948
UL https://hdl.handle.net/20.500.14352/107948
LA eng
NO Navarro Cuéllar C, Martínez EB, Navarro Cuéllar I, López López AM, Rial MT, Pérez AS, Salmerón Escobar JI. Primary Maxillary Reconstruction With Fibula Flap and Dental Implants: A Comparative Study Between Virtual Surgical Planning and Standard Surgery in Class IIC Defects. J Oral Maxillofac Surg. 2021 Jan;79(1):237-248. doi: 10.1016/j.joms.2020.08.003. Epub 2020 Aug 8. PMID: 32890473.
DS Docta Complutense
RD 29 may 2025