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ISSN : 0376-4672
하악골의 연속성을 상실한 결손에 있어 악골의 결손을 심미적, 기능적으로 재건하는 것은 재건학 분야에서도 현재까지 논란이 되고 있는 분야이다. 안면부의 재건은 경조직 뿐 아니라 연조직도 대체 할 수 있어야 하며 골격적 버팀목(buttress) 역할을 수행할 수 있어야 할 뿐만 아니라 저작 등의 치아의 기능을 수행할 수 있는 토대를 마련해 주어야 한다.
Vascularized iliac crest flap include bone tissue of good quality and quantity for mandible segmental defect. Even if fibular flap can contain longer bone tissue, iliac crest has esthetic shape for mandible body reconstruction and large height for implant. Conventional vascularized iliac crest osteomyocutaneous flap is too bulky for reconstruction of intraoral soft tissue defect. But modified flap can reduce soft tissue volume, so is good for functional reconstruction of oral mucosa. It takes only one month for completely replace oral mucosa. The final mucosal texture is much better than other skin paddle flap, especially for implant prosthesis. Donor site morbidity of this method looks same level or less with other modalities functionally and socially. In case of oral mucosa-mandible combined defect, vascularized iliac crest with internal oblique muscle flap shows good outcomes for hard and soft tissue.
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