The “Beveled One-and-a-Half-Barrel” Fibula Transplant with Virtual Surgical Planning and CT-Guided Implant Surgery for Prosthetic Rehabilitation in Posterior Mandible Defects: A Pictorial Essay

Olindo Massarellia, Silvio Mario Melonib more
a Olindo Massarelli

MD, PhD, FEBOMFS; Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy. Correspondence: Principal address: Maxillofacial Surgery Unit, University Hospital of Sassari, Viale San Pietro 43/B, Sassari 07100, Italy. Permanent address: Maxillofacial Surgery Operative Unit, Santa Maria delle Scotte University Hospital, Viale Mario Bracci 16, 53100 Siena, Italy. E-mails: (Olindo Massarelli) Instagram: @dott.olindomassarelli ResearchGate: ORCID:

b Silvio Mario Meloni

DDS, PhD; Associate Professor, Medical Surgical and Experimental Sciences, University of Sassari, Italy.

March 12, 2022

J Diagn Treat Oral Maxillofac Pathol 2022;6:39–59.

Under a Creative Commons license


Massarelli O, Meloni SM. The “beveled one-and-a-half-barrel” fibula transplant with virtual surgical planning and CT-guided implant surgery for prosthetic rehabilitation in posterior mandible defects: a pictorial essay. J Diagn Treat Oral Maxillofac Pathol 2022;6(3):39–59.


In this study, we present a new case of segmental oro-mandibular reconstruction with fibula transplant, first described as “beveled one-and-a-half-barrel” shape, highlighting tips and tricks for not jeopardizing its vascularity and our technical considerations for adequate dental rehabilitation. A report of all reconstructive stages and secondary implant-rehabilitation phases, outlining the reliability of this new technique together with a comparative analysis of advantages and disadvantages of different reconstructive techniques for alveolar bone reconstruction was made. This technique was applied in our hospital for a 49-year-old Caucasian woman with an aggressive recurrent ameloblastoma of the left mandible. Post-operative computed tomography with clinical intra- and extraoral photography are presented. We believe that this pictorial essay presented in our paper could be useful as a goal-oriented step-by-step highly detailed surgical guide to achieve a reliable and good shaped bone hardware for further dental rehabilitation in case of segmental posterolateral mandibular reconstruction.


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