Implant rehabilitation in fibular free flap reconstruction: A retrospective study of cases at 1-18 years following surgery

Publication date: Available online 8 July 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Davide Sozzi, Giorgio Novelli, Rebeka Silva, Stephen T. Connelly, Gianluca M. Tartaglia
PurposeTo determine the dental implant and prostheses success rate in a cohort of patients who underwent a vascularized free fibula flap (FFF) for maxillary or mandibular reconstruction.MethodsThe investigators implemented a retrospective cohort study composed of patients who had undergone primary or secondary FFF reconstruction jaw surgery plus placement of 2 to 6 implants in the reconstructed arch, which were restored with an implant-supported prosthesis. The sample was composed of all patients who underwent FFF surgery between 1998 to 2012 and had either simultaneous or secondary dental implant placement. A total of 28 patients met inclusion criteria. Of these, 22 patients participated in the retrospective review. Patients were examined by an independent observer between January-December 2015. In addition, all patients completed a questionnaire to access satisfaction with the implant-supported prosthesis.ResultsThe patient cohort consisted of 12 males and 10 females, age 12-70 years. A total of 100 implants were placed, 92 implants in fibular bone and 8 implants in native bone. In the maxilla, 35 implants were placed into fibular bone and 4 into native bone (11 in irradiated patients and 28 in non-irradiated patients). In the mandible, 57 implants were placed into fibular bone and 4 into native bone (15 in irradiated patients and 46 in non-irradiated patients). The mean follow-up after implant loading was 7.8 years (range 1.3-17.5 years). The implant survival rate was 98% (95% CI: 92.2%-99.5%). No statistically significant difference was found in implant success between maxillary and mandibular implants, or between radiated and non-radiated bone. The prostheses success rate, determined by clinical exam and patient satisfaction, was 100%.ConclusionThe results of this study suggest that implant survival is high and implant-supported prostheses are a reliable rehabilitation option in patients whose jaws have been reconstruction with a FFF.



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