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Is Mandibular reconstruction using vascularized fibula flaps and dental implants a reasonable treatment?


Jacobsen, Christine; Kruse, Astrid; Lübbers, Heinz-Theo; Zwahlen, Roger; Studer, Stephan; Zemann, Wolfgang; Seifert, Burkhardt; Grätz, Klaus-Wilhelm (2014). Is Mandibular reconstruction using vascularized fibula flaps and dental implants a reasonable treatment? Clinical Implant Dentistry and Related Research, 16(3):419-428.

Abstract

PURPOSE: this study retrospectively analyzed the rate of screwed implant insertion and risk factors in patients undergoing mandibular reconstruction with microsurgical revascularized fibula flaps. METHODS: This study retrospectively analyzed all patients with microvascularized fibula grafts between 1997 and 2005. Collected data included general data and risk factors (e.g., smoking, alcohol use), and irradiation was the main predictor variable. The number of patients rehabilitated with dental implants and the implant success rate were evaluated, possible influencing factors were identified, and the results were compared with previously published data. RESULTS: The sample included 33 patients (17 men, 16 women; mean age: 52 years); 76% were smokers, 42% drank alcohol regularly, and 73% had undergone mandible irradiation. Twenty-three patients received 140 screw-retained implants for dental rehabilitation. Twenty-three implants were lost. Overall 1- and 5-year implant survival rates were 94% and 83%, respectively. Implant survival rates were 86% in non-irradiated mandibular bone, 86% in non-irradiated grafted fibular bone, 82% in irradiated mandibular bone, and 38% in irradiated grafted fibular bone. CONCLUSION: This study showed that the use of dental implants in patients with fibula flaps is an appropriate and successful option for dental rehabilitation, even in those with risk factors such as smoking, alcohol use, and irradiation. Implant placement in irradiated grafted bone seems to be a high-risk procedure.

Abstract

PURPOSE: this study retrospectively analyzed the rate of screwed implant insertion and risk factors in patients undergoing mandibular reconstruction with microsurgical revascularized fibula flaps. METHODS: This study retrospectively analyzed all patients with microvascularized fibula grafts between 1997 and 2005. Collected data included general data and risk factors (e.g., smoking, alcohol use), and irradiation was the main predictor variable. The number of patients rehabilitated with dental implants and the implant success rate were evaluated, possible influencing factors were identified, and the results were compared with previously published data. RESULTS: The sample included 33 patients (17 men, 16 women; mean age: 52 years); 76% were smokers, 42% drank alcohol regularly, and 73% had undergone mandible irradiation. Twenty-three patients received 140 screw-retained implants for dental rehabilitation. Twenty-three implants were lost. Overall 1- and 5-year implant survival rates were 94% and 83%, respectively. Implant survival rates were 86% in non-irradiated mandibular bone, 86% in non-irradiated grafted fibular bone, 82% in irradiated mandibular bone, and 38% in irradiated grafted fibular bone. CONCLUSION: This study showed that the use of dental implants in patients with fibula flaps is an appropriate and successful option for dental rehabilitation, even in those with risk factors such as smoking, alcohol use, and irradiation. Implant placement in irradiated grafted bone seems to be a high-risk procedure.

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5 citations in Web of Science®
1 citation in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research
04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > Center for Dental Medicine > Clinic for Cranio-Maxillofacial Surgery
Dewey Decimal Classification:610 Medicine & health
Date:2014
Deposited On:20 Dec 2012 11:14
Last Modified:05 Apr 2016 16:12
Publisher:Wiley-Blackwell
ISSN:1523-0899
Publisher DOI:https://doi.org/10.1111/cid.12004
PubMed ID:22998581

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