Precise management of thick skin flaps after mandibular fibula muscle flap transplantation and implant restoration: a case report

Implant-supported restorations are critical for rehabilitating jawbone defects and restoring patients' occlusal function. Achieving proper fit and occlusal relationship with opposing teeth, as well as establishing a healthy peri-implant soft tissue seal, is essential to prevent infection and promote maintainability. This article presents a case involving the precise management of a thick soft tissue flap and the placement of an implant-supported restoration following mandibular reconstruction with a fibula flap. It offers a comprehensive overview of the diagnostic approach, surgical procedures, and prognostic outcomes, with the aim of providing valuable insights for clinical practice. The review spans the entire treatment process-from the planning of Stage I implant surgery, including optimal implant positioning and type selection, to the intraoperative techniques for layered debulking and flap preconditioning. It further discusses the evaluation of soft tissue thickness and the application of a customized healing abutment during Stage II surgery, as well as strategies for long-term oral hygiene maintenance.