Outcomes and influencing factors of dental implants in fibula, iliac crest, and scapula free flaps: a retrospective case-control study

TY - JOUR

T1 - Outcomes and influencing factors of dental implants in fibula, iliac crest, and scapula free flaps: a retrospective case-control study

AU - Kaiser, Marina

AU - Burg, Simon

AU - Speth, Ulrike

AU - Cotter, Marie-Luise

AU - Smeets, Ralf

AU - Gosau, Martin

AU - König, Daniela

N1 - © 2024. The Author(s).

PY - 2024/2/9

Y1 - 2024/2/9

N2 - PURPOSE: Reconstruction with vascularized bone grafts after ablative surgery and subsequent dental rehabilitation with implants is often challenging; however, it helps improve the patient's quality of life. This retrospective case-control study aimed to determine the implant survival/success rates in different vascularized bone grafts and potential risk factors.METHODS: Only patients who received implants in free vascularized bone grafts between 2012 and 2020 were included. The free flap donor sites were the fibula, iliac crest, and scapula. The prosthetic restoration had to be completed, and the observation period had to be over one year after implantation. Implant success was defined according to the Health Scale for Dental Implants criteria.RESULTS: Sixty-two patients with 227 implants were included. The implant survival rate was 86.3% after an average of 48.7 months. The causes of implant loss were peri-implantitis (n = 24), insufficient osseointegration (n = 1), removal due to tumor recurrence (n = 1), and osteoradionecrosis (n = 5). Of all implants, 52.4% were classified as successful, 19.8% as compromised, and 27.8% as failed. Removal of osteosynthesis material prior to or concurrent with implant placement resulted in significantly better implant success than material not removed (p = 0.035). Localization of the graft in the mandibular region was associated with a significantly better implant survival (p = 0.034) and success (p = 0.002), also a higher Karnofsky Performance Status Scale score with better implant survival (p = 0.014).CONCLUSION: Implants placed in vascularized grafts showed acceptable survival rates despite the potential risk factors often present in these patient groups. However, peri-implantitis remains a challenge.

AB - PURPOSE: Reconstruction with vascularized bone grafts after ablative surgery and subsequent dental rehabilitation with implants is often challenging; however, it helps improve the patient's quality of life. This retrospective case-control study aimed to determine the implant survival/success rates in different vascularized bone grafts and potential risk factors.METHODS: Only patients who received implants in free vascularized bone grafts between 2012 and 2020 were included. The free flap donor sites were the fibula, iliac crest, and scapula. The prosthetic restoration had to be completed, and the observation period had to be over one year after implantation. Implant success was defined according to the Health Scale for Dental Implants criteria.RESULTS: Sixty-two patients with 227 implants were included. The implant survival rate was 86.3% after an average of 48.7 months. The causes of implant loss were peri-implantitis (n = 24), insufficient osseointegration (n = 1), removal due to tumor recurrence (n = 1), and osteoradionecrosis (n = 5). Of all implants, 52.4% were classified as successful, 19.8% as compromised, and 27.8% as failed. Removal of osteosynthesis material prior to or concurrent with implant placement resulted in significantly better implant success than material not removed (p = 0.035). Localization of the graft in the mandibular region was associated with a significantly better implant survival (p = 0.034) and success (p = 0.002), also a higher Karnofsky Performance Status Scale score with better implant survival (p = 0.014).CONCLUSION: Implants placed in vascularized grafts showed acceptable survival rates despite the potential risk factors often present in these patient groups. However, peri-implantitis remains a challenge.

KW - Humans

KW - Free Tissue Flaps/transplantation

KW - Retrospective Studies

KW - Dental Implants/adverse effects

KW - Case-Control Studies

KW - Peri-Implantitis

KW - Fibula/transplantation

KW - Ilium/surgery

KW - Quality of Life

KW - Scapula/surgery

U2 - 10.1186/s40729-024-00522-5

DO - 10.1186/s40729-024-00522-5

M3 - SCORING: Journal article

C2 - 38334913

VL - 10

SP - 8

JO - INT J IMPLANT DENT

JF - INT J IMPLANT DENT

SN - 2198-4034

IS - 1

ER -