Comparison of Vascularized Osteoperiosteal Femur Flaps and Nonvascularized Femur Grafts for Reconstruction of Mandibular Defects: An Experimental Study

Purpose: The aim of this study was to compare the vascularized osteoperiosteal femur flaps (VFFs) and the nonvascularized femur grafts (NVFGs) for reconstruction of the mandibular defects of pigs. Materials and Methods: Eight adult domestic pigs were used. The defects created in the mandibular angle were reconstructed with VFFs in 4 pigs (group 1) and NVFGs in the other 4 pigs (group 2). All the pigs were killed after 3 months of heating. Undecalcified and decalcified sections were prepared for histomorphometric analysis and histologic examination. Radiodensitometric absorptiometry was used to assess the differences in bone mineral density between the 2 groups. Results: The bone volume to the total measured volume, trabecular thickness, and trabecular number were significantly greater in the VFF group than in the NVFG group (P < .05). However, the trabecular separation was significantly lower in the VFF group than the NVFG group (P = .029). Although the VFF group had a greater bone mineral density value than the NVFG group, the difference was not statisticatly significant (P = .057). In histologic examination, the viability of bone in the VFF group, enchondral bone healing, and lamellar bone formation in the NVFG group were apparent. Conclusions: The results of this study suggest that NVFGs have a greater bone resorption rate than do VFFs. Furthermore, the histomorphometric results imply that reconstruction of the mandibular defects with vascularized osteoperiosteal femur flaps will provide greater strength. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:1174-1183, 2009