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Reconstructed mandibular defects: fibula free flaps and osseointegrated implants
E D Roumanas1, B L Markowitz, J A Lorant
1Division of Maxillofacial Prosthetics, Plastic and Reconstructive Surgery, University of California, Los Angeles, USA.
Plastic and Reconstructive Surgery
|February 1, 1997
Summary
Dental implants in fibula flaps offer successful oromandibular reconstruction. Osseointegrated implants support prostheses, with radiation therapy being a key factor in bone loss around implants.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Reconstructive Surgery
Background:
- Microvascular fibula flaps are crucial for oromandibular defect reconstruction.
- Implant-retained prostheses are essential for functional rehabilitation following these reconstructions.
Purpose of the Study:
- To evaluate the success of osseointegrated implants placed in fibula flaps for oromandibular reconstruction.
- To assess factors influencing implant survival and prosthetic rehabilitation outcomes.
Main Methods:
- Retrospective analysis of 20 patients undergoing fibula flap reconstruction.
- Placement of 71 osseointegrated implants, with immediate or secondary placement options.
- Functional loading and prosthetic restoration of uncovered implants, with follow-up ranging from 1 to 49 months.
Main Results:
- Of 54 uncovered implants, 46 were functional and 3 were being restored.
- Implant survival rate was high, with only 1 failure to osseointegrate among the 54 uncovered implants.
- Radiographic bone loss was observed exclusively in implants exposed to postoperative radiation therapy.
Conclusions:
- Osseointegrated implants in fibula flaps provide a reliable foundation for oromandibular prosthetic rehabilitation.
- Postoperative radiation therapy is a significant risk factor for bone loss around dental implants in these reconstructions.
- Careful planning regarding implant placement and radiation exposure is crucial for long-term success.