Functional results of dental restoration with osseointegrated implants after mandible reconstruction

We reviewed the cases of 20 cancer patients (mean age 47.4 years) in whom osseointegrated implants were used for dental restoration after mandibular reconstruction between January of 1988 and December of 1994. Seventy-one implants were placed into bone flaps (n = 60) or native mandible (n = 11), an average of 3.55 per patient (range, 2 to 5). Successful integration occurred in 91.5 percent (65 of 71); there were five early failures and one late failure, with no significant difference between the number lost in microvascular flaps (5 of 60) and native mandible (1 of 11) (as determined by Fisher's exact test). Functional evaluation included assessments of diet, speech, and cosmesis. Based on our review, we concluded that (1) implants enhance dental restoration in selected patients, and (2) microvascular bone flaps, including the fibula and iliac crest, are well suited for dental implant restoration.