Abstract: PURPOSE: To investigate the effect of vascularized free fibular flap in repairing segmental mandibular defects. METHODS: Eighty patients with segmental mandibular defects treated in our hospital from June 2015 to May 2018 were enrolled. Both groups of patients were operated by the same group of medical staff with more than 5 years of clinical experience. Patients were divided into 2 groups using a random number table method, 40 in each group. Patients in the control group underwent non-vascularized iliac bone graft while patients in the experimental, group underwent vascularized free fibular bone flap repair. The graft survival, pain, quality of life, negative emotions and complications were compared between the two groups using SPSS 22.0 software package. RESULTS: There was no significant difference in the scores of the proximal gingival papilla, distal gingival papilla, labial margin and labial margin (P>0.05). The gingival texture, color score and total score of the root surface of the experimental group were significantly higher than the control group (P<0.05). The scores of VAS, anxiety and depression in both groups were significantly decreased after operation, but the decrease in the experimental group was greater(P<0.05). Physical function, psychological and social function, life quality of the two groups were significantly increased, but the increase of the experimental group was greater (P<0.05).Three cases (7.5%) developed complications in the control group, including 1 case of pneumonia, 1 case of infection and 1 case of wound recurrence. Two cases(5%) in the experimental group developed of complications, including 1 case of wound recurrence and 1 case of pneumonia, the difference was not statistically significant (P>0.05). CONCLUSIONS: Repair of mandibular segmental defect with vascularized free fibular bone flap can significantly improve the overall effect, relieve pain and negative emotion, improve quality of life of patients and decrease incidence of complications.

Key words: Vascularized free fibular bone flap, Mandible, Segmental defect