Simultaneous Placement of Endosseous Implants in Free Fibula Flap for Reconstruction of Mandibular Resection Defects

Abstract

Functional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. Large bone defects in the mandible due to ablation for tumors may generate a series of problems, as far as function and esthetics of the patient is concerned. The use of free bone flaps for mandibular reconstruction has the obvious advantage of being a well vascularized tissue that can withstand the hostile environment of the oral cavity. Fibular bone presents favorable conditions for implant-supported prosthetic rehabilitation, due to its diameter and the good quality of its cortical bone. The outcome of current study supports the use of simultaneous placement of endosseous implants in free fibula flap for reconstruction of mandibular resection defects with better clinical, aesthetic, and functional outcomes.

Factors Affecting Complete Oral Rehabilitation in Patients With Vascularized Free Fibula Flap Mandibular Reconstruction: A 10-Year Retrospective Study

“…It is important to not only evaluate the implant survival rate but also report the implant success rate. However, the interpretation of the implant success rates reported to date, which have ranged from 89% to 97.1%, would be confounded by differences in the definitions of implant survival and success that were applied 24 …”

“…However, the interpretation of the implant success rates reported to date, which have ranged from 89% to 97.1%, would be confounded by differences in the definitions of implant survival and success that were applied. 24 First, most studies have included some modified form of the implant success criteria described by Albrektsson et al 25 as painfree and immobile implant without clinical or radiographic signs of peri-implant infection, and without vertical bone resorption exceeding 1.5 mm in the first year and 0.2 mm per year in the following years. The main drawback of that definition of success is that the implants do not have to be useful for supporting a prosthesis, which was key to the definition used in this study.…”

The comprehensive on-demand 3D bio-printing for composite reconstruction of mandibular defects

“…Composite tissue reconstruction of the mandible usually does not mean the simultaneous restoration of dentition, even in reconstruction with OCFF. Although some OCFF case reports suggested simultaneous dental implant installation, the indication seems to be still limited [ 9 , 102 ]. Prolonged surgical time and ischemic time for immediate implant placement may impact flap survival and can increase a risk for direct injury to the vessel pedicle [ 103 ].…”

Meta-analysis of the survival rate and postoperative infection rate of primary and secondary implants after vascularized fibula transplantation for reconstruction of jaw defects

“…For patients with benign tumors, implants are usually implanted 6 months after the surgery. On one hand, delayed implantation can avoid influencing the blood supply recovery of fibula; on the other hand, some studies believe that early implanted implants has poor osseointegration and lower success rate [ 5 , 6 ]. There are also some disadvantages to secondary implantation, including longer waiting times for repairs and need a second operation.…”