title: Success of dental implants in vascularised fibular osteoseptocutaneous flaps used as onlay grafts after marginal mandibulectomy.
abstract: We have evaluated the survival of dental implants placed in vascularised fibular flap onlay grafts placed over marginal mandibulectomies and the effects on marginal bone loss of different types of soft tissue around implants under functional loading. From 2001-2009 we studied a total of 11 patients (1 woman and10 men), three of whom had had ameloblastoma and eight who had had squamous cell carcinomas resected. A total of 38 dental implants were placed either at the time of transfer of the vascularised fibular ostoseptocutaneous flaps (nine patients with 30 implants) or secondarily (two patients with eight implants). Four patients were given palatal mucosal grafts to replace intraoral skin flaps around the dental implants (n=13), and the other seven had the skin flaps around the dental implants thinned (n=25) at the second stage of implantation of the osteointegrated teeth. All vascularised fibular osteoseptocutaneous flaps were successfully transferred, and all implants survived a mean (range) of 73 (33-113) months after occlusal functional loading. The mean (SD) marginal bone loss was 0.5 (0.3) mm on both mesial and distal sides in patients who had palatal mucosal grafts, but 1.8 (1.6) mm, and 1.7 (1.5) mm, respectively, on the mesial and distal sides in the patients who had had thinning of their skin flaps. This difference is significant (p=0.008) with less resorption of bone in the group who had palatal mucosal grafts. Palatal mucosa around the implants helps to reduce resorption of bone after functional loading of implants.
authors: Department of Oral and Maxillofacial surgery, Chang Gung Memorial Hospital, Chang Gung University and Medical College, Taipei, Taiwan. Electronic address: c430502@adm.cgmh.org.tw.
authors: Y-M
authors: YM
authors: Chang
authors: Department of General dentistry at Taipei Hospital, Chang Gung Memorial Hospital, Chang Gung University and Medical College, Taipei, Taiwan.
authors: Y-H
authors: YH
authors: Pan
authors: Department of Prthodontics at Linko Hospital, Chang Gung Memorial Hospital, Chang Gung University and Medical College, Taipei, Taiwan.
authors: Y-F
authors: YF
authors: Shen
authors: Department of Oral and Maxillofacial surgery.
authors: J-K
authors: JK
authors: Chen
authors: Department of Plastic & Reconstruction Surgery, Chang Gung Memorial Hospital, Chang Gung University and Medical College, Taipei, Taiwan.
authors: N F
authors: NF
authors: ALDeek
authors: Department of Plastic & Reconstruction Surgery, Chang Gung Memorial Hospital, Chang Gung University and Medical College, Taipei, Taiwan.
authors: F-C
authors: FC
authors: Wei
mesh_terms: D016301:Alveolar Bone Loss; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D007284:Inlays; D008297:Male; D063168:Mandibular Osteotomy; D013524:Surgical Flaps
chemical_list: D015921:Dental Implants
keywords: Dental implant; Fibular bone flap; Marginal mandibulectomy