Osseointegrated implant survival, success and prosthodontic outcomes in composite free flaps: A 10‐year retrospective cohort study

Khadembaschi, Darius; Russell, Peter; Beech, Nicholas; Batstone, Martin

doi:10.1111/clr.13822

Cited by 10 publications

(11 citation statements)

References 46 publications

(77 reference statements)

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“…The systematic review encompassed 18 studies, with 17 being retrospective [ 12 – 14 , 16 – 28 , 30 ] and one prospective cohort study [ 29 ]. In total, 774 patients (445 males, 252 females, and 77 unreported) were involved, and 1988 dental implants were used in free fibula grafts.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies focused solely on mandibular defects [ 18 , 19 , 23 , 26 , 27 , 29 ], while the others examined both maxillary and mandibular resections. Additionally, four studies assessed implants placed in natural bones [ 12 , 21 , 25 , 26 ], and three studies compared implant success rates across different graft types [ 14 , 20 , 30 ], such as scapula, DCIA, and MFC, alongside free fibular grafts.…”

Section: Resultsmentioning

confidence: 99%

“…Dental implant systems offer numerous benefits, including the restoration of chewing ability, cosmetic appearance, jawbone preservation, and prevention of bone loss [ 10 ]. The integration of dental implants in reconstructed mandibles has been shown to provide satisfactory results [ 11 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis

Tahmasebi

Keykha

Hajisadeghi

et al. 2023

Maxillofac Plast Reconstr Surg

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Background This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region. Main text We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane’s CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case–control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran’s Q test and the I2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. Conclusions Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis

Tahmasebi

Keykha

Hajisadeghi

et al. 2023

Maxillofac Plast Reconstr Surg

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“…Several authors largely highlight that peri-implantitis is directly related to inability to perform proper oral hygiene procedures [ 22 ]. Plus, patients who underwent reconstructive surgery suffer from limitations in oral opening because of oral vestibule contracture, reporting difficulty in accessing the abutments for effective home-care oral hygiene procedures [ 23 ]. As many studies demonstrated that higher plaque levels [ 24 , 25 ] and lack of accessibility for cleaning at implant level [ 21 ] are both significantly associated with peri-implantitis, oral hygiene performed by patients therefore represents a key component in preventing peri-implant diseases [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and periodontal conditions of dental implants placed in free fibula flaps (FFF): a retrospective study with a mean follow-up of 6 years

Lombardo,

D’Agostino,

Nocini

et al. 2023

Clin Oral Invest

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Objectives Up-to-date literature regarding long-term success of implant rehabilitations after microvascular reconstructions with free fibula flap (FFF) is still very scarce. This study aimed to evaluate clinical outcomes, especially related to oral hygiene conditions, of patients rehabilitated with this technique. Materials and methods A total of 25 patients who underwent maxillofacial reconstructive surgery with FFF were retrospectively evaluated for soft tissues conditions, oral hygiene habits, and implant survival and success, assessed with a mean follow-up of 6 (range 2–15) years after loading. Results Fourteen patients received full-arch fixed prostheses and 11 removable bar-supported overdentures. At the follow-up evaluation, 52% of prostheses did not allow proper accessibility for oral hygiene. Overall prosthetic survival was 100%, and implant survival and success were respectively 93.6% and 72%. Prevalence of peri-implantitis was 29% at implant level and that at patient level 96%. Conclusions Six-year clinical outcomes of this study reveal that poor oral hygiene practices and compliance by patients who underwent maxillofacial reconstruction with FFF are significantly associated with peri-implant disease. Clinical relevance Findings of the present study underline the need by clinicians for a careful assessment, in reference to a specific implant therapy, of patient’s prosthetic accessibility for oral hygiene procedures.

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“…For the dental rehabilitation of the reconstructed bone, a dental implant was mainly used. Implant success was defined as an implant being comfortable to the patient and functionally supporting a prosthesis [7]. Primary implant stability is the most important feature for implant survival and success during implant installation.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Dental Implant Rehabilitation in the Reconstructed Jaw by Deep Circumflex Iliac Artery Flap, a Retrospective Study

Bang

Kim

et al. 2022

Applied Sciences

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The purpose of this study is to analyze the clinical results of the implant rehabilitation for a jaw reconstructed by the deep circumflex iliac artery (DCIA) flap. A total of 13 patients were included in this study from 2010 to 2020. Medical records were collected retrospectively and analyzed. The mandible was involved in 10 cases and the maxilla was in 3 cases. The average width of the DCIA flap was 8.6 mm, and the height was 20.65 mm. A total of 41 dental implants with a diameter of 3.9–5.0 mm and a length of 10.0–11.5 mm were placed at an average of 12.3 months after the reconstruction. The average follow-up period after delivering a permanent prosthesis was 15 months (range, 2 to 51 months) and the overall mean follow-up period was 48 months. In all, 3 implants of the total 41 implants were removed. The DCIA flap is the most suitable for reproducing the original contour of the original jawbone compared with the fibular flap. In addition, the height and width of the reconstructed bone is appropriate for implant placement, which is advantageous for the rehabilitation of oral function and aesthetics using the implant.

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Osseointegrated implant survival, success and prosthodontic outcomes in composite free flaps: A 10‐year retrospective cohort study

Cited by 10 publications

References 46 publications

Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis

Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis

Clinical outcomes and periodontal conditions of dental implants placed in free fibula flaps (FFF): a retrospective study with a mean follow-up of 6 years

Analysis of Dental Implant Rehabilitation in the Reconstructed Jaw by Deep Circumflex Iliac Artery Flap, a Retrospective Study

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