Harnessing the potential of the free fibula osteoseptocutaneous flap in mandible reconstruction.

Abstract

The free fibula osteoseptocutaneous flap remains the first choice for segmental mandible and contiguous soft-tissue defect reconstructions in most situations. Several important principles are described that should be respected during skin paddle design: fibula contouring, insetting, and fixation, and dental implant osseointegration. Recent advancements that address difficulties in height contouring, particularly at the anterior segment, are highlighted. The presented methods can help provide an optimal mandibular reconstruction that restores mechanical functions, facial aesthetics, and complete dental competence. Efficient interdisciplinary communication and teamwork are necessary throughout the longitudinal care of the patient if optimal results are to be achieved.