The purpose of this study is to analyze the clinical results of the implant rehabilitation for a jaw reconstructed by the deep circumflex iliac artery (DCIA) flap. A total of 13 patients were included in this study from 2010 to 2020. Medical records were collected retrospectively and analyzed. The mandible was involved in 10 cases and the maxilla was in 3 cases. The average width of the DCIA flap was 8.6 mm, and the height was 20.65 mm. A total of 41 dental implants with a diameter of 3.9–5.0 mm and a length of 10.0–11.5 mm were placed at an average of 12.3 months after the reconstruction. The average follow-up period after delivering a permanent prosthesis was 15 months (range, 2 to 51 months) and the overall mean follow-up period was 48 months. In all, 3 implants of the total 41 implants were removed. The DCIA flap is the most suitable for reproducing the original contour of the original jawbone compared with the fibular flap. In addition, the height and width of the reconstructed bone is appropriate for implant placement, which is advantageous for the rehabilitation of oral function and aesthetics using the implant.

The iliac crestal flap is often used in maxillofacial reconstruction surgery because it has a similar bone contour to jaw bone. However, complications occur frequently in this flap, and the avulsion fracture of the anterior superior iliac spine (ASIS) occurs only in rare cases. The purpose of this study is to evaluate the risk factors affecting fractures that may occur after iliac crestal flap harvesting. In this study, we performed preoperative and postoperative CT scans of the iliac bones of 22 patients who underwent iliac crestal flaps between February 2013 and July 2019. Three of these patients had fractures within 1 month after surgery. After converting DICOM files to a three-dimensional model using Mimics software, some reference points were defined for analysis. The patients were classified into fracture and non-fracture groups. The patients’ age and sex, harvested bone, residual bone and absolute bed rest (ABR) periods were investigated. The patients’ age and sex were not associated with fracture occurrence. There was a statistically significant difference in the width of the anterior–superior part of residual bone. The fracture group showed statistically significantly shorter ABR periods. In the case of the iliac crestal flap, it was found that the factors that can affect the occurrence of fractures are the width of the residual bone and the ABR period. Iliac avulsion fracture can be prevented when the remaining bone is sufficient and the ABR period is prolonged sufficiently.