Background and objectives: The aim of this study is to analyze the reconstruction of small to moderate size intraoral defects following malignant tumors excision using the nasolabial inferiorly based flap. This is a secure and easy flap, with high vascularity that can be realized in one stage and allows dental implant placement for immediate or delayed prosthetic rehabilitation.
Methods: From 2005 to 2009, a group of 5 patients with oral cancer underwent reconstruction of intraoral defects using a one-stage nasolabial flap. During the same procedure osseointegrated dental implants were placed. A retrospective analysis was performed.
Results: In all cases, the defects were secondary to intraoral squamous cell carcinomas resection that included alveolar gum, floor of mouth, buccal mucosa and alveolar bone with adjacent teeth. Based on our clinical protocols, all patients underwent supraomohyoidal neck dissection (bilateral in two cases). Immediately after excision of tumour, 4 osseointegrated dental implants were inserted to achieve implant support rehabilitation (overdenturs with bars). Inferiorly based nasolabial flaps were performed as a single stage procedure by dissecting a transbuccal tunnel and de-epithelizing of the portion of the flap which is placed inside the tunnel. Follow-up ranged from 2 to 5 years. A single case of recurrence was detected in one patient who was treated satisfactorily with a new resection. All dental implants achieved good osseointegration and could be rehabilitated.
Conclusion: The nasolabial flap is an easy and useful option for reconstruction of small and moderate intraoral defects with satisfactory functional and aesthetic results. Donor site can be closure directly with minimal morbidity. This flap offers the possibility of using osseointegrated implants during the same procedure to achieve a prosthetic rehabilitation.
Key words : nasolabial flap; prosthetic rehabilitation; intraoral reconstruction.