Facial plast Surg 2003; 19(1): 087-094
DOI: 10.1055/s-2003-39138
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Enhancement of the Fibula Free Flap by Alveolar Distraction for Dental Implant Restoration: Report of a Case

Lawrence Levin1 , Lee Carrasco1 , Amin Kazemi2 , Ara Chalian3
  • 1University of Pennsylvania Hospital, Department of Oral and Maxillofacial Surgery
  • 2Private practice, Cherry Hill, NJ
  • 3University of Pennsylvania Hospital, Department of Otorhinolaryngology
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Publication History

Publication Date:
09 May 2003 (online)


We describe the utilization of distraction osteogenesis in the free fibular microvascular bone graft to the mandible for increasing bone height for future osseointegrated dental implants. Successful reconstruction of a resected mandible requires restoration of both function and esthetic form. Although current reconstructive techniques restore anterior-posterior and lateral projection, often the graft's vertical height is not sufficient for the placement of osseointegrated dental implants and subsequent oral prosthesis. The patient was a sixteen-year-old male who was found to have a large desmoplastic fibroma of the left mandible, which was resected. The defect was successfully restored with a free fibular microvascular bone graft and reconstruction plate. Nevertheless, the patient had persistent problems with mastication and it was decided to perform a segmental osteotomy of the neomandible. Two internal vertical distraction devices were then placed in the mandible. The appliances were then activated five days postoperative, twice a day, for a total of 14 days. At that time 1.5 cm of distraction had occurred and the patient was placed in a consolidation phase for four months. The patient then had sufficient bone height and was restored with 8 osseointegrated dental implants.