The use of free vascularized fibula flaps for bony reconstruction has proved its success as a substitution for the resected bone and in some instances, the surrounding soft tissues

The aim of this case series study is to evaluate the stability of the dental implants placed in free fibula flaps substituting a resected mandible and/or maxilla when they are immediately loaded with the All-On-Four technique along with the patient satisfaction.

• Preoperative phase :

Patients will be subjected to:

• Case history including personal data, medical, surgical and family history.
• Clinical examination
• Radiographic examination using computed tomography (C.T) bony and soft tissue window.
• Diagnostic studying casts.
• Operative phase :

All cases will undergo surgery under local regional anesthesia. Injection of local anaesthesia (Articaine 4% and 1:100000 epinephrine) for regional infiltration. Sequential drilling then insertion of the dental implant fixtures and abutments on which the prefabricated temporary prosthesis will be fixed.

• Postoperative care Proper postoperative instructions will be given to the patient such as strict oral hygiene measures and soft diet for 1 month, in addition to the postoperative medications including antibiotics (amoxicillin 1g capsules b.d.s ) and analgesics (diclofenac potassium 50mg as needed). Adherence to follow ups will be also instructed

Inclusion Criteria

• Patients with reconstructed jaws with free fibula flaps in either or both jaws.
• Age group : from 15 to 60 years old
• No sex predilection
• Patients with no contraindications to surgical intervention Exclusion Criteria
• Patients with systemic condition counteracting with the surgical procedure.