Bone Harvesting Techniques for Free Vascularized Bone Grafting in Oral and Maxillofacial Surgery

Defects in osseous facial structures can present a significant surgical challenge. Osseous defects can result from a variety of factors, including trauma, tumor resection, or congenital abnormalities. The reconstruction of these defects requires careful planning and execution to ensure that functional and aesthetic outcomes are achieved. Several surgical techniques can be used to reconstruct osseous facial defects, including bone grafts, distraction osteogenesis, and custom implants. Each technique has its advantages and limitations, and the choice of technique will depend on the size and location of the defect, as well as the patient’s overall health and expectations. In addition to surgical techniques, advances in computer-assisted planning and manufacturing have created custom implants and surgical guides that can improve surgical accuracy and reduce the risk of complications. These technologies can also help to optimize surgical outcomes by allowing for precise preoperative planning and simulation (Thorwarth et al. 2008). Despite these advances, the reconstruction of osseous facial defects remains a complex surgical challenge that requires a multidisciplinary approach. Close collaboration between surgeons, dentists, and other specialists is essential to achieving optimal outcomes for patients with these types of defects (Wilkman et al. 2019). To restore the area’s functional and anatomical characteristics, reconstruction following the removal of tissue due to trauma or disease must be performed using suitable tissue. In many cases, a composite flap is the best option for this type of reconstruction. A composite flap is a surgical technique that involves transferring a combination of tissues, such as skin, muscle, and bone, from one part of the body to another. This technique allows for the transfer of functional tissues to the area of reconstruction, thereby restoring the missing anatomy and functionality of the area. The selection of the appropriate composite flap depends on the defect’s size and location, the surrounding tissues’ quality, and the desired functional and aesthetic outcomes. The most commonly used composite flaps for facial reconstruction include the radial forearm flap, the fibula flap, and the scapular flap. In addition to the choice of the composite flap, the surgical technique used for reconstruction must also consider the patient’s general health and the overall complexity of the procedure. A multidisciplinary approach involving various medical professionals, such as plastic surgeons, oral and maxillofacial surgeons, and otolaryngologists, is often necessary to achieve the best possible outcome for the patient (Suh et al. 2021; Wilkman et al. 2017).