Dental implant‐based oral rehabilitation in patients reconstructed with free fibula flaps: Clinical study with a <scp>follow‐up</scp> 3 to 6 years

Göker, Funda; Baj, A.; Bolzoni, Alessandro; Maiorana, Carlo; Giannì, Aldo Bruno; Fabbro, Massimo Del

doi:10.1111/cid.12928

Cited by 13 publications

(13 citation statements)

References 44 publications

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“…18 Additionally, dental rehabilitation in free flap patients improves post-operative quality of life and mastication, underscoring the importance of considering dental rehabilitation in pediatric patients. 19,20 Future studies may focus on the implications of flap healing with immediate dental implant placement and rehabilitation. Despite the lack of dental restoration, patients achieved intelligible speech following reconstructions.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Pelligrino in 2018 demonstrated a 95% success rate of dental implant placement into fibula free flaps used for orofacial reconstruction, with a low incidence of complications including implantitis 18 . Additionally, dental rehabilitation in free flap patients improves post‐operative quality of life and mastication, underscoring the importance of considering dental rehabilitation in pediatric patients 19,20 . Future studies may focus on the implications of flap healing with immediate dental implant placement and rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

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Post‐operative Outcomes in Pediatric Patients Following Facial Reconstruction With Fibula Free Flaps

et al. 2022

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Educational Objective Assess outcomes of pediatric facial reconstruction with fibula free flaps. Objectives Free flap reconstruction of complex maxillofacial defects in pediatric patients is rare. Post‐operative complications, donor site morbidity, impact on craniofacial growth, and oro‐dental rehabilitation are unknown. Our study assesses the outcomes of pediatric maxillofacial reconstruction with composite fibula free flaps. Study Design Retrospective chart review. Methods Multi‐institutional retrospective chart review from 2000 to 2020 on pediatric patients undergoing maxillomandibular reconstruction with fibula free flaps. Results Eighty‐seven patients underwent 89 surgeries; 5 maxillary and 84 mandibular defects. Median age: 12 years. Defects were acquired following resection of sarcoma/carcinoma 44% or benign tumors 50%. 73% of cases had immediate free flap reconstruction. Closing osteotomies were reported in 74%; 1 in 40%, 2 in 27%, and more than 2 in 6.7%. Hardware was used in 98% and removed in 25%. 9.2% demonstrated long‐term hardware exposure, greater than 3 months following reconstruction. Short‐term complications: wound infection 6.7%, flap salvage/failure 2.2%, fistula 1.1%, and compromised craniofacial growth: 23%. Two patients developed trismus. Long‐term fibula donor site complications: hypertrophic scarring: 3.4%, dysesthesia: 1.1%, and long‐term gait abnormality: 1.1%. Dental rehabilitation was performed in 33%. Post‐operative speech outcomes showed 94% with fully intelligible speech. Conclusion Pediatric maxillary and mandible defects repaired with fibula free flaps demonstrated complication rates comparable to the adult free flap population. Long‐term follow‐up did not demonstrate adverse outcomes for craniofacial growth. Hardware for flap retention was utilized and remained in place with minimal exposure. Post‐operative gait abnormality is rare. Level of Evidence 3 Laryngoscope, 133:302–306, 2023

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Post‐operative Outcomes in Pediatric Patients Following Facial Reconstruction With Fibula Free Flaps

et al. 2022

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“…Oral rehabilitation success might decrease because of the insu cient retention and stability of the prosthesis. Survival rates of free aps and subsequent implants were reported by various authors with promising results [22,[24][25][28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

“…The pre/post-operative and surgical protocol was described in detail in the previous publications by the same team of authors [28,29]. In brief, the rst stage maxillofacial operation was performed simultaneously by two teams.…”

Section: Methodsmentioning

confidence: 99%

“…The inclusion criterion was oncologic patients who needed maxillofacial reconstruction and oral rehabilitation with dental implants after resection and reconstructive surgery, with or without adjunctive radiation therapy. The patients that had no implant inserted or had dental implant inserted in other clinics after The pre/post-operative and surgical protocol was described in detail in the previous publications by the same team of authors [28,29]. In brief, the rst stage maxillofacial operation was performed simultaneously by two teams.…”

Section: Methodsmentioning

confidence: 99%

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Oral Rehabilitation of Oncology Patients With Microvascular Free Flaps With a Follow-Up of 2 to 6 Years

Göker

Baj

Bolzoni

et al. 2021

Preprint

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BACKGROUND: Reconstruction with free flaps after radical cancer surgery in terms of function and esthetics can be quite demanding. The aim of this study was to evaluate retrospectively oral rehabilitation with microvascular free flaps and dental implants for maxillofacial reconstruction in oncologic patients with a minimum follow-up of 2 years after implant insertions.METHODS: The study consisted of 17 patients diagnosed with either squamous cell carcinoma, fusocellular carcinoma, or mucoepidermoid carcinoma. The reconstruction of the maxillofacial defects was done with microvascular free flaps (free fibular flap, antero-lateral thigh flap, or radial forearm flap). Implants were inserted on the average 30.2±15.5 months after reconstructive operations. A total of 74 implants were inserted. Mean follow up after maxillo-facial surgery was 6.16 years (mean 73.93±14.48 months). Mean follow up after implant insertions was 3.61 years (mean 43.50±12.96). Primary outcome was implant survival. Secondary outcome was evaluation of post-surgical complications.RESULTS: There were surgical revisions in seven patients after reconstructive surgery with flaps, mainly due to tumor relapse. Complications were seen in 11 patients. 1 implant was lost in a female patient 15 months after placement. Overall implant survival rate was 97.5%. No relations were found between implant survival rate and gender, type of tumor, type of microvascular free flap, radiation therapy, chemotherapy, and prosthesis type.CONCLUSION: According to the results of this study, oral rehabilitation with dental implants inserted in free flaps for maxillofacial reconstruction after ablative oncologic surgery can be considered as a safe treatment modality with successful outcomes.

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Vestibuloplasty and its impact on the long-term survival and success of dental implants in irradiated and non-irradiated patients after head and neck tumor therapy: a retrospective study

Wüster

Sachse

et al. 2023

Clin Oral Invest

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Objectives This study aimed to evaluate the influence of vestibuloplasty on the clinical success and survival of dental implants in head and neck tumor patients. Materials and methods A retrospective single-center study was conducted. All patients received surgical therapy of a tumor in the head or neck and underwent surgical therapy and, if necessary, radiotherapy/radiochemotherapy. Patients with compromised soft tissue conditions received vestibuloplasty using a split thickness skin graft and an implant-retained splint. Implant survival and success and the influence of vestibuloplasty, gender, radiotherapy, and localizations were evaluated. Results A total of 247 dental implants in 49 patients (18 women and 31 men; mean age of 63.6 years) were evaluated. During the observation period, 6 implants were lost. The cumulative survival rate was 99.1% after 1 year and 3 years and 93.1% after 5 years for patients without vestibuloplasty, compared to a survival and success rate of 100% after 5 years in patients with vestibuloplasty. Additionally, patients with vestibuloplasty showed significantly lower peri-implant bone resorption rates after 5 years (mesial: p = 0.003; distal: p = 0.001). Conclusion This study demonstrates a high cumulative survival and success rate of dental implants after 5 years in head and neck tumor patients, irrespective of irradiation. Patients with vestibuloplasty showed a significantly higher rate of implant survival and significantly lower peri-implant bone resorption after 5 years. Clinical relevance Vestibuloplasty should always be considered and applied if required by the anatomical situations to achieve high implant survival/success rates in head and neck tumor patients.

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Dental implant‐based oral rehabilitation in patients reconstructed with free fibula flaps: Clinical study with a follow‐up 3 to 6 years

Cited by 13 publications

References 44 publications

Post‐operative Outcomes in Pediatric Patients Following Facial Reconstruction With Fibula Free Flaps

Post‐operative Outcomes in Pediatric Patients Following Facial Reconstruction With Fibula Free Flaps

Oral Rehabilitation of Oncology Patients With Microvascular Free Flaps With a Follow-Up of 2 to 6 Years

Vestibuloplasty and its impact on the long-term survival and success of dental implants in irradiated and non-irradiated patients after head and neck tumor therapy: a retrospective study

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