The “Beveled One-and-a-Half-Barrel” Fibula Transplant with Virtual Surgical Planning and CT-Guided Implant Surgery for Prosthetic Rehabilitation in Posterior Mandible Defects: A Pictorial Essay

Abstract

In this study, we present a new case of segmental oro-mandibular reconstruction with fibula transplant, first described as “beveled one-and-a-half-barrel” shape, highlighting tips and tricks for not jeopardizing its vascularity and our technical considerations for adequate dental rehabilitation. A report of all reconstructive stages and secondary implant-rehabilitation phases, outlining the reliability of this new technique together with a comparative analysis of advantages and disadvantages of different reconstructive techniques for alveolar bone reconstruction, was made. This technique was applied in our hospital for a 49-year-old Caucasian woman with an aggressive recurrent ameloblastoma of the left mandible. Post-operative computed tomography with clinical intra- and extraoral photography are presented. We believe that this pictorial essay presented in our paper could be useful as a goal-oriented step-by-step highly detailed surgical guide to achieve a reliable and good shaped bone hardware for further dental rehabilitation in case of segmental posterolateral mandibular reconstruction.