Bone remodeling of the fibula segment as a form of neocondyle after free vascularized bone transfer: a report of two cases

• Published in: Journal of the Korean Association of Oral and Maxillofacial Surgeons Vol. 49; no. 6; pp. 354 - 359
• Main Authors: Park, Han Ick, Chang, Hoon Je, Lee, Jee-Ho
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Oral and Maxillofacial Surgeons 31.12.2023; 대한구강악안면외과학회
• Subjects: Case Report; 치의학; Case reports; Fibula free flap; Mandibular reconstruction; Neocondyle regeneration
• ISSN: 2234-7550; 2234-5930
• DOI: 10.5125/jkaoms.2023.49.6.354

The temporomandibular joint is a unique structure composed of the joint capsule, articular disc, mandibular condyles, glenoid fossa of the temporal bone, surrounding ligaments, and associated muscles. The condyle is one of the major components of a functional temporomandibular joint. Reconstruction of large mandibular defects involving the condyle is a surgical challenge for oral and maxillofacial surgeons. To restore large mandibular defects, there are different options for free flap method such as fibula, scapula, and iliac crest. Currently, the vascularized fibula free flap is the gold standard for reconstruction of complex mandibular defects involving the condyle. In the present report, neocondyle regeneration after mandible reconstruction including the condyle head with fibula free flap was evaluated. In this report, two patients were evaluated periodically, and remodeling of the distal end of the free fibula was observed in both cases after condylectomy or mandibulectomy. With preservation of the articular disc, trapezoidal shaping of the neocondyle, and elastic guidance of occlusion, neocondyle bone regeneration occured without ankylosis. Preservation of the articular disc and maintenance of proper occlusion are critical factors in regeneration of the neocondyle after mandible reconstruction.