Implant Dental Rehabilitation of Fibula-Free Flap Reconstructed Jaws

Abstract

Background: The possibility of placing dental fixtures in the reconstructed regions allows us to overcome the problems related to dental rehabilitation with removable prosthesis. The aim of this study was to assess the clinic-radiological outcome in a series of patients who underwent fibula flap jaws reconstruction and rehabilitation with implant-supported prosthesis with a minimum follow-up of 24 months.

Material and methods: The study included 10 patients who underwent reconstruction with fibula free flap between 2010 and 2018. Albrektsson criteria were used to define the implant survival. The follow-up evaluation was performed according to a standardized protocol including clinical examination, radiological evaluation (panoramic radiograph) and patient interview.

Results: A total of 45 implants were positioned.The time between mandibular reconstruction and implant placement ranged from 13 months to 39 months.The prosthesis used was fixed in 6 cases and supported overdenture in 4 cases.No implant failure was observed.Regarding implant survival no infections were observed in these series. Nine patients out of 10 had no pain and signs of mobility. Seven patients out of 10 had absence of peri-implant radiolucency at the panoramic radiograph.One patient presented with an overgrowth of granulomatous soft tissue around the implant abutments that caused pain.

Conclusions: Implant placed in vascularized bone grafts are a safe and reliable opportunity to rehabilitate patients following mandibular resection. The results of this series demonstrate a high survival rate for implants placed in reconstructed mandibles with an improvement of the quality of life.