The concept of "two arches" in mandibular reconstruction.

Abstract

To optimize the outcome of the free fibula flap in mandibular reconstruction, the central portion of the mandible can be divided into upper and lower arches during preoperative evaluation and planning. We present 2 cases requiring mandibular reconstruction with free fibula flap after ameloblastoma excision, to illustrate the "two arches" concept and its applicability in mandibular reconstruction. The postoperative course was uneventful. Follow-up at 24 months postoperative revealed a considerable restoration in facial appearance and provided functional teeth. Recent advances in mandibular reconstruction could be further refined through the application of the "two arches" concept. This approach simplifies surgical planning in selective cases and directs the attention of surgeons to the specific needs of the 2 distinct regions of the mandible during reconstruction.