Objective. To analyze the feasibility of free fibula flap (FFF) for reconstruction of alveolar part of the mandible with severe atrophy appreciating bone stability after dental implant insertion and prosthetic rehabilitation with implant-supported devices.

Material and methods. There were 10 females aged 36—65 years with totally edentulous severely atrophic mandibles who underwent lower jaw alveolar part reconstruction using FFF, subsequent dental implant insertion and prosthetic rehabilitation with implant-supported devices. We used cephalometry to analyze height of atrophic and reconstructed mandible and transplanted FFF. FFF volume was analyzed using CT data segmentation.

Results. The height of reconstructed mandible immediately after surgery was 21.20±1.87 mm with a loss of 1.16±0.22 mm (5.48±1.05%) for 3-6 months after dental implant functional loading. The height of transplanted FFF was 11.24±1.10 mm with a non-significant loss of 0.99±0.52 mm for 3-6 months after prosthetic rehabilitation and maintaining about 91.21% of initial value in 14 months after reconstruction. Initial volume of FFF was 9.42±1.71 cm3. This value has changed by –0.46±1.14 cm3 in 3—6 months after prosthetic rehabilitation.

Conclusion. FFF ensures reconstruction of the whole mandibular alveolar part with subsequent dental implant insertion and implant-supported prosthetic rehabilitation with predictable functional and aesthetic outcomes.

Keywords. mandibular atrophy, fibula flap, dental implants