Autologous Ilium Grafts: Long-Term Results on Immediate or Staged Functional Rehabilitation of Mandibular Segmental Defects Using Dental Implants after Tumor Resection

Duohong Zou; Wei Huang; Feng Wang; Shen Wang; Zhiyong Zhang; Chenpin Zhang; Darnell Kaigler; Yiqun Wu

doi:10.1111/cid.12169

Autologous Ilium Grafts: Long-Term Results on Immediate or Staged Functional Rehabilitation of Mandibular Segmental Defects Using Dental Implants after Tumor Resection

Clin Implant Dent Relat Res. 2015 Aug;17(4):779-89. doi: 10.1111/cid.12169. Epub 2013 Oct 31.

Authors

Duohong Zou^{1

2}, Wei Huang¹, Feng Wang¹, Shen Wang¹, Zhiyong Zhang¹, Chenpin Zhang¹, Darnell Kaigler³, Yiqun Wu¹

Affiliations

¹ Departments of Oral and Craniofacial Implant and Oral and Maxillofacial Surgery, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China.
² Department of Dental Implant Centre, Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, China.
³ Department of Periodontics and Oral Medicine in School of Dentistry, University of Michigan and Michigan Center of Oral Health Research (MCOHR), Ann Arbor, MI, USA.

PMID: 24172127
DOI: 10.1111/cid.12169

Abstract

Background: It is a challenge for clinicians to restore oral function in patients with segmental defects of the mandible because of tumor extirpation. Dental implant therapy following vascularized autologous ilium grafts is an effective method to restore oral function in patients with mandibular segmental defects.

Purpose: The aim of this retrospective study was to investigate the long-term clinical outcomes of ilium grafts combined with immediate or staged mandibular dental implant therapy to restore craniofacial defects resulting from tumor resection.

Materials and methods: Over a 5-year period (2000-2004), 32 patients who underwent mandibular segmental resection for tumors were treated with vascularized ilium grafts to augment bone volume. Seventeen patients received phase I therapy (immediate placement of implants), and 15 patients underwent phase II therapy (delayed placement of implants). A total of 110 dental implants were placed in these patients for mandibular restoration of the defective areas. Information regarding implant success and survival rates, marginal bone loss, soft tissue inflammation, complications of prosthesis, and patient satisfaction for the 8 to 12 years following oral reconstruction was obtained from patient records.

Results: Although there was mild evidence of bone graft resorption, the vascularized autogenous ilium bone grafts were successful in all patients. The cumulative patient survival and success rate of the implants were 96.4% and 91.8%, respectively. The mean peri-implant bone resorption ranged from 1.0 to 1.2 mm over the 8- to 12-year follow-up period. The annual mean number of complications/repairs was from 0.11 to 0.07 per patient during the 8- to 12-year follow-up. Over 80% of the patients were fully satisfied with their restoration of oral function.

Conclusions: This study demonstrates that reconstruction of mandibular segmental defects because of resection of mandibular tumors using dental implants therapy combined with vascularized autogenous ilium grafts is an effective method to restore oral function.

Keywords: dental implant; ilium; mandibular segmental defects; oral function reconstruction; tumor; vascularized autogenous bone grafts.

Publication types

Clinical Trial, Phase I
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Bone Transplantation / methods*
Dental Implants*
Female
Humans
Ilium / surgery*
Male
Mandible / surgery
Plastic Surgery Procedures / methods*
Retrospective Studies
Transplantation, Autologous / methods*

Substances

Dental Implants