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Retrospective three-dimensional analysis of bone resorption volumes of free microvascular scapular and fibular grafts

  • Author Footnotes
    1 Juergen Taxis and Christopher-Philipp Nobis contributed equally to this work.
    Juergen Taxis
    Correspondence
    Corresponding author at: Department of Oral and Maxillofacial Surgery, Medical Faculty, University of Erlangen-Nuremberg, Glueckstraße 11, 91054 Erlangen, Germany.
    Footnotes
    1 Juergen Taxis and Christopher-Philipp Nobis contributed equally to this work.
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054 Erlangen, Germany
    Search for articles by this author
  • Author Footnotes
    1 Juergen Taxis and Christopher-Philipp Nobis contributed equally to this work.
    Christopher-Philipp Nobis
    Footnotes
    1 Juergen Taxis and Christopher-Philipp Nobis contributed equally to this work.
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054 Erlangen, Germany
    Search for articles by this author
  • Elisabeth Grau
    Affiliations
    Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, Liebigstraße 12, 04103 Leipzig, Germany
    Search for articles by this author
  • Marco Kesting
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054 Erlangen, Germany
    Search for articles by this author
  • Tobias Moest
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054 Erlangen, Germany
    Search for articles by this author
  • Author Footnotes
    1 Juergen Taxis and Christopher-Philipp Nobis contributed equally to this work.
Published:August 22, 2022DOI:https://doi.org/10.1016/j.bjoms.2022.08.002

      Abstract

      Defects in head and neck regions are standardly treated with microvascular grafts, such as free scapular (SFF) and fibular flaps (FFF), which are subject to a certain amount of bone resorption over time. The aim of this study was the 3-dimensional evaluation of bone resorption volume in both grafts. Over a period of 10 years, computed tomograms (CT) of patients with mandibular reconstructions with SFFs and FFFs were examined. The respective grafts were segmented as well as 3-dimensionally measured. Furthermore, factors such as gender, age, nicotine abuse, previous disease with type 2 diabetes, and adjuvant therapies, were examined for their influence. A total of 211 CT scans from 67 patients (40 SFFs and 27 FFFs) were included in the study. SFFs showed slightly higher median bone volumes (87.60% at 730 days and 86.55% at 1500 days) than FFFs (84.40% at 730 days and 82.10% at 1500 days). When final volumes were considered, FFFs had higher mean volume values (88.22%) than SFFs (83.82%), with significant correlation between resorption volume and time progression (r = 0.357, p = 0.024). All previously mentioned factors had no significant effect on bone resorption. Bone volumes of FFFs showed postoperative volume reductions similar to those of SFFs, with isolated SFFs having markedly lower volume values. The choice of a microvascular graft for reconstruction in the mandible proves difficult regarding bone resorption. The presented results may support decisions about future transplantations.

      Keywords

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