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Factors affecting survival and usefulness of implants placed in vascularized free composite grafts used in post-head and neck cancer reconstruction.

AbstractBACKGROUND:
Bone-containing vascularized grafts have been used successfully to reconstruct post-cancer surgical defects. Dental implants can be placed in these bone-containing grafts to allow implant-supported prosthodontic reconstruction of these patients.
PURPOSE:
The aim of this study was to evaluate the survival of dental implants used in the rehabilitation of subjects treated with bone-containing vascularized grafts to compare usability of implants placed at the time of reconstruction and after healing.
MATERIALS AND METHODS:
A cross-sectional study was undertaken to examine survival rates of implants placed in vascularized bone-containing grafts either immediately at the time of surgical reconstruction or after 3 months healing. Other factors such as graft type, whether radiation therapy was given, and implant type were recorded.
RESULTS:
A total of 41 patients had 145 implants placed in 47 vascularized bone-containing flaps. Increased failure rate of implants was seen in immediately placed implants. There was also a significant increase in the number of osseointegrated implants that were prosthodontically unusable or sub-optimally placed in the immediate placement group. Radiation therapy was associated with a significant increase in failure rate. Modern implant surfaces appeared to perform better than machined/turned surfaces. Graft donor site did not influence implant survival.
CONCLUSION:
This study demonstrated the difficulties encountered with immediate placement of dental implants at the time of post-cancer reconstructive surgery.
AuthorsMichael R Fenlon, Andrew Lyons, Suzanne Farrell, Kalpesh Bavisha, Avijit Banerjee, Richard M Palmer
JournalClinical implant dentistry and related research (Clin Implant Dent Relat Res) Vol. 14 Issue 2 Pg. 266-72 (Apr 2012) ISSN: 1708-8208 [Electronic] United States
PMID19843102 (Publication Type: Comparative Study, Journal Article)
Copyright© 2009 Wiley Periodicals, Inc.
Chemical References
  • Dental Implants
Topics
  • Bone Transplantation (pathology)
  • Cross-Sectional Studies
  • Dental Implantation, Endosseous (methods)
  • Dental Implants (classification)
  • Dental Prosthesis Design
  • Dental Prosthesis, Implant-Supported
  • Dental Restoration Failure
  • Dentistry, Operative
  • Head and Neck Neoplasms (radiotherapy, surgery)
  • Humans
  • Mandible (surgery)
  • Maxilla (surgery)
  • Osseointegration (radiation effects)
  • Radiotherapy, Adjuvant
  • Plastic Surgery Procedures (methods)
  • Surface Properties
  • Surgery, Oral
  • Survival Analysis
  • Transplant Donor Site (pathology)
  • Treatment Outcome
  • Wound Healing (physiology)

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