Histological evaluation of microsurgical revascularized bone in the intraoral cavity: Does it remain alive?

Introduction: Microsurgical revascularized fibula graft is a standard for the reconstruction of mandible or maxilla after major resection. Usually, screwed implants are inserted as a second procedure for dental rehabilitation. A lot has been published about the advantages of vascularized bone grafts, but until now there is only little information about long‐term viability of inserted bone grafts. Material and Methods: In this study, previously inserted vascularized fibula bone grafts were examined histologically. Bone biopsies were taken during dental implant insertion procedure in average of 19 months after insertion of bone grafts from 10 patients. Results: All bone biopsies showed partially or totally necrotic bone, although clinical examination and postoperative monitoring of the revascularized bone remained unremarkable. Conclusion: The results of histological examination are surprising, due to the fact of previous insertion of a vascularized bone graft and pretended osseointegration of inserted dental implants with satisfying primary stability. Therefore, one would expect vital bone. For better understanding how much viability is really necessary for sufficient remodeling of inserted bone grafts for adequate functional load, further studies should be performed. © 2011 Wiley‐Liss, Inc. Microsurgery, 2011.