Nowadays, it is well known that microsurgical jaw reconstruction with free fibula flap is a reliable therapeutic method. Only 25% of the patients obtain a complete oral rehabilitation and the average number of surgeries required is four after the primary reconstruction.

Objective: The aim of this study was to introduce a classification system of complementary surgeries after free fibula flap reconstruction for complete oral prosthesis rehabilitation.

Study design: The authors analyzed 11 reconstructive surgeries of the jaws with fibula free flaps during the period of one year. Only in 4 cases a complete oral rehabilitation was reached. The additional surgeries required were: 1 tongue reconstruction, 2 vestibuloplasty, 2 skin graft, 1 distraction osteogenesis, 1 corrective osteotomy and 17 implants were placed.

Results: The average number of surgeries performed in each patient was 3; 1 implant didn’t osseintegrated and 2 could not be used (sleep implant).

Conclusion: After the primary reconstructive surgery the main problems in oral rehabilitation were the inadequate soft tissue and unfavorable bone flap positioning. Although the results were satisfactory, more emphasis should be placed during initial planning in the first reconstructive surgery.

Conflict of interest: None declared.