Morphologic study of mandibles in Japanese patients for mandibular reconstruction with fibula free flaps

Background. In mandibular reconstruction with a fibula flap, 3-dimensional models are sometimes used but are not available to all plastic surgeons. To establish a simpler method, we performed a morphologic study of the mandible. Methods. Three-dimensional images of the mandible from 79 Japanese patients were analyzed. Four theoretical osteotomy points were placed on each image and the lengths of each segment and the angles between every 2 segments were measured. Results. The SDs of the angle formed by the right and left canines and the left mandibular angle; the angle formed by the left canine, the left mandibular angle, and the left condyle; and the segment between the canines were so small that these values would easily be exceeded by manipulation errors during an osteotomy. Conclusion. Mandibular bones show a close similarity among Japanese patients. Acceptably accurate osteotomies can thus be performed in Japanese patients without requiring accurate templates.