Clinical outcome of dental implants placed in fibula-free flaps used for the reconstruction of maxillo-mandibular defects following ablation for tumors or osteoradionecrosis.
OBJECTIVE
(a) To evaluate the clinical outcome of fibula revascularized flaps used for the reconstruction of maxillary and mandibular defects due to resection for tumors or osteoradionecrosis and (b) to evaluate the survival and success rates of implants placed in the reconstructed areas.


METHODS
In a 8-year period (1995-2002), 59 patients, 38 males and 21 females, aged from 13 years to 69 years (mean age: 48.7 years), presenting with maxillary and mandibular defects due to resection for tumors or osteoradionecrosis, were reconstructed with fibula-free flaps. Of the 59 patients, 16 received 71 implants for the prosthetic rehabilitation of the reconstructed edentulous areas.


RESULTS
Out of 59 fibula-free flaps, three failed and had to be removed, nine underwent partial necrosis involving the bone segment and/or the skin paddle but survived, while the remaining 47 healed uneventfully. The mean follow-up of patients after the reconstruction was 55 months (range: 24-120 months). The cumulative survival rate of fibula-free flaps was 94.9%. The mean follow-up of the 16 patients treated with dental implants and implant-supported prostheses was 50.2 months (range: 24-96 months). The cumulative implant success and survival rates of implants were 98.6% and 93.1% respectively.


CONCLUSIONS
The reconstruction of maxillo-mandibular defects following ablation for tumors or osteoradionecrosis with fibula-free flaps has been demonstrated to be a reliable technique with good long-term results. Implants placed in the reconstructed areas were demonstrated to integrate normally, with success and survival rates comparable to those obtained in case of implants placed in native bone.
Unit of Oral Surgery, Department of Medicine, Surgery, and Dentistry, San Paolo Hospital, University of Milan, Milan, Italy. matteo.chiapasco@unimi.it
Matteo
M
Chiapasco
Federico
F
Biglioli
Luca
L
Autelitano
Eugenio
E
Romeo
Roberto
R
Brusati
D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008336:Mandibular Diseases / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery*; D008437:Maxilla / Q000601:surgery; D008439:Maxillary Diseases / Q000601:surgery; D008441:Maxillary Neoplasms / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010025:Osteoradionecrosis / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D016019:Survival Analysis; D016896:Treatment Outcome
D015921:Dental Implants