Abstract
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.
Keywords
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Article info
Publication history
Published online: November 09, 2019
Accepted:
October 18,
2019
Identification
Copyright
© 2019 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.
