REVIEWS   

Minerva Stomatologica 2004 July-August;53(7-8):417-28

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Maxillary post-traumatic outcome correction. Literature review and personal experience. Part III: loss of maxillary substance (free flaps-distraction osteogenesis)

D’Agostino A., Toffanetti G., Trevisiol L., Ferrari F., Furlani M., Albanese M.

Revascularised free flaps retain dual vascularisation, both periosteal and medullary, undoubtedly present optimal survival and minimal re-absorption in view of the prevalence of osteogenetic rather than osteoclastic phenomena. A revascularised free bone flap involves the transfer of a certain amount of bone tissue, whether or not associated with a muscular, skin and/or facial component, with the features of an axial flap, dissecting the vascular stalk of the donor site and re-anastomosing both the arterial and the venous components on to recipient vessels in the site of the primary defect. The vessels in question measure only about 2-4 mm, so that micro-surgery techniques must be applied. For bone defects less than 6 cm, with upkeep of the mandibular or maxillary cortical bone and preservation of the soft tissues, with residual bone of at least 8 mm in height and 4 mm in thickness, alveolar distraction may represent a valid alternative to bone grafts, at the same time as ensuring an increase of the alveolar bone and intraoral soft tissues involved in the distraction process.