Reconstruction of Post-Traumatic Maxillary Ridges Using a Radial Forearm Free Flap and Allogeneic Tissue-Engineered Bone Grafts

Abstract

Post-traumatic maxillary alveolar ridge defect presents a unique reconstructive challenge due to the lack of soft tissue volume that is required for traditional bone graft techniques. In addition, the curvilinear shape and relatively small-sized defect make osteocutaneous free flap such as the fibula an approach that is excessive and difficult for a good cosmetic outcome. With an effort to minimize surgical morbidities, reduce length of hospital stay, and maximize esthetic result, we turn to a novel technique that utilizes a combination of bone tissue engineering and radial forearm free flap for reconstruction of maxillary ridge defect. The concept of bone tissue engineering satisfies all three basic principles of osteoregeneration for a successful graft. The application of a versatile soft tissue free flap such as the radial forearm serves to maximize the volume gain and limit failure rate of the graft, as well as producing excellent esthetic outcome.