Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction
Open Access
- 1 October 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Chinese Medical Journal
- Vol. 121 (19), 1861-1865
- https://doi.org/10.1097/00029330-200810010-00002
Abstract
Functional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. The osteocutaneous fibula free flap in combination with simultaneous or second stage insertion of dental implants has exhibited growing popularity for such reconstructions. This study was aimed at evaluating the clinical status and the success rates of dental implants inserted in fibula-free flaps for orofacial reconstruction following ablation of tumors. We conducted a clinical follow-up study based on 29 patients after oral tumor surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 5-year period. The follow-up protocol included clinical examination and radiological evaluation. The clinical records of the patients were reviewed retrospectively. Information on treatment modalities, dentition, implant parameters, and prostheses was collected and analyzed. In general, a high primary stability for implants placed into the free fibula grafts was achieved. The 1-year and 5-year cumulative survival rates of the implants were 96% and 91%, respectively, using the Kaplan-Meier method. The 1-year and 5-year cumulative success rates of implants placed into the fibula bone grafts were 95% and 87%, respectively. The main reasons for failure of the dental implants were infection, tumor recurrence and soft tissue proliferation. The fibula flap presents many advantages for implant placement, but its limited height sometimes makes implant-supported prosthetic rehabilitation difficult. Vascularized fibula bone grafts provide a firm basis for the placement of dental implants in jaw reconstruction. Implants placed in fibula bone grafts were shown to integrate normally. The double-barrel technique, or increasing the height of the fibula flap by vertical distraction osteogenesis before implant placement in the mandible, is desirable from a functional and esthetic point of view.Keywords
This publication has 16 references indexed in Scilit:
- Oral rehabilitation after treatment for head and neck malignancyHead & Neck, 2005
- Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: An outcome analysis of primary bony union and endosseous implant successHead & Neck, 1999
- Primary Insertion of Osseointegrated Dental Implants into Fibula Osteoseptocutaneous Free Flap for Mandible ReconstructionPlastic and Reconstructive Surgery, 1998
- Functional Results of Dental Restoration with Osseointegrated Implants after Mandible ReconstructionPlastic and Reconstructive Surgery, 1998
- Osseointegrated implants in the head and neck cancer patientHead & Neck, 1997
- Experience with the osteocutaneous fibula flap: an analysis of 24 consecutive reconstructions of composite mandibular defectsJournal of Cranio-Maxillofacial Surgery, 1996
- ErratumInternational Journal of Oral & Maxillofacial Surgery, 1996
- Vascularized Bone Flaps in Oromandibular Reconstruction: A Comparative Anatomic Study of Bone Stock From Various Donor Sites to Assess Suitability for Enosseous Dental ImplantsJAMA Otolaryngology–Head & Neck Surgery, 1994
- Functional mandibular reconstruction of patients with oral cancerOral Surgery, Oral Medicine, Oral Pathology, 1989
- THE FREE VASCULARIZED BONE GRAFTPlastic and Reconstructive Surgery, 1975