Clinical Evaluation of Implants in Radiated Fibula Flaps

Salinas, Thomas J.; Desa, V.; Katsnelson, Alexander; Miloro, Michael

doi:10.1016/j.joms.2009.09.104

Cited by 57 publications

(47 citation statements)

References 24 publications

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“…Twenty‐seven studies informed of the death occurrences among the patients during the follow‐up. Eighteen studies had patients who were also submitted to adjunctive chemotherapy. In 2 studies, all patients were submitted to chemotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…Radiotherapy may result in progressive fibrosis of blood vessels and soft tissues, in xerostomia, in osteoradionecrosis, and in reduction of bone‐healing capacity, among others . Because of the cumulative effects of radiation on bone vascularity, the regenerative capacity of these tissues is limited, and this may have a deleterious impact on subsequent implant osseointegration …”

Section: Introductionmentioning

confidence: 99%

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Dental implants in irradiated versus nonirradiated patients: A meta‐analysis

2015

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The purpose of the present meta-analysis was to test the null hypothesis of no difference in dental implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants and being previously irradiated in the head and neck region versus nonirradiated patients against the alternative hypothesis of a difference. The study suggests that irradiation negatively affects the survival of implants, as well as the difference in implant location (maxilla vs mandible), but there is no statistically significant difference in survival when implants are inserted before or after 12 months after radiotherapy. The study failed to support the effectiveness of hyperbaric oxygen therapy in irradiated patients. It was observed that there was a tendency of lower survival rates of implants inserted in the patients submitted to higher irradiation doses. The results should be interpreted with caution because of the presence of uncontrolled confounding factors in the included studies.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dental implants in irradiated versus nonirradiated patients: A meta‐analysis

2015

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“…We included all cases rehabilitated with implant retention, even if that was the main reason for publication (146); consequently, the figures for rehabilitation with implants are probably exaggerated to some extent. 35% (3287/9499, Table 8) of reconstructed cases included implant-retained rehabilitation and so this review can only provide limited evidence of the overall rate of implant-retained prosthesis in general use.…”

Section: Rehabilitationmentioning

confidence: 99%

Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years

Brown

Lowe

Kanatas³

et al. 2017

British Journal of Oral and Maxillofacial Surgery

138

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A systematic review was undertaken to explore the mandibular reconstruction techniques and outcomes, using composite free flaps.A total of 9499 mandibular defects were reconstructed with 6178 fibulas, 1380 iliac crests, 1127 composite radials, 709 scapulas, 63 serratus anterior and rib, 32 metatarsals and 10 lateral arm flaps including humerus. The flap failure rate was higher for the iliac crest at 6.2% (66/1059) compared to 3.4% (202/6018) if the fibula, radial or scapula was used (p<0.001). Details relating to osteotomy rate, non-union and fistula rates were evaluated. Iliac crest was most often rehabilitated with implantretained prosthesis (44%, 100/229), compared to 26% (605/2295) (p<0.001) if another flap was used. Changing trends over the study period were not apparent, regarding flap choice or related complications.Although we are able to show some significant differences relating to the type of flap used, it is disappointing to present the underreporting of fundamental outcomes such as the osteotomy rate, non-union and fistula rates. This review demonstrates the need for more comprehensive and consistent outcome reporting, that will allow the comparison of different techniques for similar defects.

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“…However, Raoul et al suggested that implant placement should be avoided in areas that have received radiotherapy doses of more than 50 Gy (Raoul et al, 2009 Raoul et al reported that implant loss occurred only in 1 irradiated vascularized fibula flap among a total of 18 implants placed in 6 patients, representing a success rate of 94% (Raoul et al, 2009). Salinas et al reported a 72.5% osseointegration rate for 51 implants placed in 22 patients (Salinas et al, 2010). They found that the radiation dose had statistically significant effect on implant success.…”

Section: Dental Implantsmentioning

confidence: 99%

Mandibular Reconstruction with Vascularized Osseous Free Flaps: a Review of the Literature

Kim

Nam

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Purpose: This article reviews a few of the commonly used types of vascularized osseous free flaps in maxillofacial reconstruction, which still represents the gold standard of restoration. We also discuss the developing concepts in maxillofacial reconstruction. Recent findings: Most of the literature reconfirms the established patterns of reconstruction with the aid of vascularized osseous free flaps. This method of freetissue transfer is also feasible in cases of osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaw. These flaps are also suitable for prosthetic restoration using osseointegrated dental implants. Summary: Vascularized osseous free flaps still remain the standard of care. Improvements upon the free-tissue transfer method employing vascularized osseous free flaps, such as distraction osteogenesis, tissue engineering, and imaging techniques, currently require further development, but these technologies could lead to improved outcomes of maxillofacial reconstruction in the near future.

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Clinical Evaluation of Implants in Radiated Fibula Flaps

Cited by 57 publications

References 24 publications

Dental implants in irradiated versus nonirradiated patients: A meta‐analysis

Dental implants in irradiated versus nonirradiated patients: A meta‐analysis

Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years

Mandibular Reconstruction with Vascularized Osseous Free Flaps: a Review of the Literature

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