National survey on implantation practices for free bone flaps: Key findings and insights

In cervico-facial oncology, reconstructive procedures aim to ensure patient survival, restore orofacial functions, and maintain esthetic outcomes. The ultimate goal of these interventions is to provide functional rehabilitation. However, dental rehabilitation following bone-free flap reconstructions remains underutilized. This study evaluates current practices in France and identify the challenges reconstructive surgeons face in implementing dental implant rehabilitation after free bone flap reconstruction in an oncological setting.

A nationwide survey was conducted across 52 French hospitals to assess practices related to free bone flap reconstructions and dental implant rehabilitation. An online questionnaire collected data on the epidemiology, rehabilitation practices, team organization, and willingness towards increasing the number of rehabilitated patients following oncological surgeries.

Nineteen centers responded, highlighting diverse practices. While most centers perform over 20 free bone flap reconstructions annually, the number of patients receiving implants post-reconstruction was relatively low, with most centers reporting between one and five implant procedures in the past year. Key obstacles to implant rehabilitation included patient irradiation (61 %), lack of financial support (61 %), absence of a practitioner network (50 %), insufficiently trained team members (33 %), risk of oncological recurrence (28 %), extended operating times for primary implantations (22 %), and difficulties with radiological follow-up due to artifacts (17 %) CONCLUSION: Despite its potential to enhance patient quality of life, dental implant rehabilitation in oncological patients remains marginal in France. This study highlights the need for standardized protocols and improved collaboration between reconstructive surgeons and dental specialists to increase the rate of rehabilitation following free bone flap reconstructions.