الفهرس 
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Abstract
The current prospective study was conducted on 10 patients that were selected and admitted for early or delayed mandibular reconstructive surgery from the outpatient who were referred to the department of Oral and Maxillofacial Surgery Faculty of Dental Medicine, Ain Shams University in the period from January 2018 till July 2021.
The patients in this study were randomly divided into two groups. First group endured anterior iliac crest grafting with delayed implant insertion while the second group endured vascularized fibular flap with delayed implant insertion.
Inclusion criteria were any patient candidate for reconstructive mandibular surgery following traumatic injuries, gunshot injuries, tumor ablative surgeries, osteomyelitis and osteonecrosis (radio or chemo) affecting any anatomical part of the mandible. While the exclusion criteria were any cardiovascular or pulmonary disease or general medical condition hindering the fitness for general anesthesia, any vascular or bone disorder compromise the healing process of grafting and previous fracture or surgeries related to the donor site affecting its harvesting.
Patients were divided into 2 groups, the first group endured anterior iliac crest grafting with delayed implant insertion while the second group endured vascularized fibular flap with delayed implant insertion.
Implant placement was done six months after performing reconstructive surgery. The prosthetic techniques employed were like those used for conventional implant retained prosthodontics. Follow- up was done for 1 year postoperatively.
Peri-implant bone stability was analyzed using intraoral radiographs, CBCT and ISQ values were measured using an ostell device. The results were then statistically analyzed.
Results showed that the bone resorption in the graft and marginal bone loss around the dental implants placed in vascularized free fibular grafts was less compared to the implants placed in non-vascularized iliac crest graft. As for the primary stability, the results showed that implants placed in vascularized free fibular grafts had much higher primary stability than implants placed in non-vascularized iliac crest graft, Survival rates of dental implants was statistically non-significant between both groups.