Anatomical characteristics of the fibula as a guide to dental implant installation.

Abstract

Dental implant placement in fibula bone is a standard of care for restoring dentition in reconstructed jaws. An observational analysis of 100 fibulas was performed using the CT component of PET-CT scans, to assess anatomical characteristics of the fibula and determine the ideal fibula region for dental implant placement. The total anatomical fibula length (TAL) was measured on each scan. After removing 6 cm of fibula from each end, five equidistant cross-sectional points were located (A-E) and analysed for four parameters: height of available bone volume for implant installation (a-d dimension), cross-sectional shape, cortical thickness, and radiodensity. The cross-sectional points were compared, and differences according to sex were investigated. Median TAL was 35.4 cm ; adequate for reconstruction of the jaws. The maximum a-d dimension was observed for cross-section C (median 11.5 mm, interquartile range 10.2-13.0 mm). Median cortical thickness ranged between 2.48 mm and 3.91 mm, and median radiodensity between 1073 HU and 1356 HU. Cross-section D more frequently showed a favourable cross-sectional anatomy: triangular with apex downwards (71%). The distal portion of the fibula (segment C-D, spanning 17.74 -23.66 cm from the head end) is deemed most favourable site for dental implants.