Clinical outcome of dental implants placed in fibula‐free flaps used for the reconstruction of maxillo‐mandibular defects following ablation for tumors or osteoradionecrosis

Chiapasco, Matteo; Biglioli, Federico; Autelitano, Luca; Romeo, Eugenio; Brusati, Roberto

doi:10.1111/j.1600-0501.2005.01212.x

Cited by 212 publications

(199 citation statements)

References 43 publications

(67 reference statements)

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“…Two methods of management of this problem has been reported in literature. 27 This includes substitution of the skin around implants with mucosal grafts from the palate to obtain firmly attached, keratinized mucosa around implants, and the topical application of silver nitrate, particularly in patients who underwent maxillary resection, as this may lead to absence of palatal mucosa with no possibility of harvesting keratinized mucosa from this site. One limitation of the fibula free flap is that its average height is seldom more than 14 mm, which leads to a step at the graft-to-residual stump interface, this can be avoided by fixation of the upper border of the flap at the level of the residual alveolar ridge.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps

Jain¹

2017

World Journal of Dentistry

193

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Introduction Functional reconstruction of jaw defects due to surgical resection is a challenge in maxillofacial surgery. The fibula free flap in combination with dental implants has exhibited growing popularity for such reconstructions. This study aimed at evaluating the clinical and functional outcome of dental implants inserted in fibula free flaps and dental implants used for orofacial reconstruction following ablation of tumors. Materials and methods A clinical follow-up study of 10 patients was conducted after oral surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 12-year period. The follow-up protocol included a clinical examination and radiological evaluation and interview using a questionnaire. Information on postoperative recovery after the surgical reconstruction phase and implant placement, type of diet, swallowing problems, speech intelligibility, lip competence, and perceived facial appearance was collected and analyzed. Results The survival rate of fibula free flap was 100%. The survival and success rates of implants placed in the fibula flaps at the end of the follow-up period were 100 and 94% respectively. Conclusion Implants placed in fibula bone grafts have been shown to integrate normally. Surgical reconstruction with vascularized fibula bone grafts followed by placement of dental implants after jaw resection can provide good clinical and functional outcomes for oral rehabilitation with a prosthesis. How to cite this article A riga P, N arayanan V, J ain A R, Philip JM, Nathan S. Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps. World J Dent 2017;8(3):171-176.

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Section: Discussionmentioning

confidence: 99%

Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps

Jain¹

2017

World Journal of Dentistry

193

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“…The bone segmented can be transplanted with muscle and skin pad that allows simultaneous reconstruction of both hard and soft tissues, with considerable improvement of facial contour and oral functions such as speech and deglutition. Further, placing dental implants in the reconstructed areas helps to overcome problems related to the dental rehabilitation with removable prostheses [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…It can be used as osteomuscular flap or osteomyocutaneous flap, providing the possibility of simultaneous reconstruction of deficient soft tissues on the intra oral side (cheek mucosa, palate, floor of the mouth, etc.). Moreover, fibular bone presents favourable conditions for implant placement and subsequent implant supported prosthetic rehabilitation, due to its diameter and the good quality of its cortical bone [1,2]. Implants are now routinely used to re-establish dentistry section mastication in reconstructed mandible.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Stresses Around Dental Implants Placed in Normal and Fibula Reconstructed Mandibular Models using Finite Element Analysis

Nesappan

Ariga

2014

JCDR

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Purpose: This study was formulated to evaluate and compare stresses around endosseous implants in various normal and fibula reconstructed mandibular models using finite element analysis method. Materials and Methods:CT scan data of a completely edentulous patient and a fibula reconstructed patient was made and the Dicom images were used to design 3-D mandibular models using software. Based on the information from the scan data, various types of reconstructed FEA models were made. Implants (fixtures) and superstructures were then embedded in each model and Von Mises stress around the neck of each implant under a vertical loading of 200 N and Horizontal load of 50 N was calculated using finite element structural analysis software. The results were compared between the reconstructed mandible and their respective normal mandible. Results:Higher stress values were obtained for all the reconstructed types under horizontal loading and in reconstructed models involving larger area of reconstruction the stress were more. In the models involving smaller area of reconstruction like symphysis alone or body alone there is no significant change in the stress values on vertical loading. Conclusion:Stresses were comparatively smaller in mandibles involving a smaller area of reconstruction. Hence, fixed prosthesis could be advised and a bar retained over denture for reconstruction for larger area of reconstruction.Thiyaneswaran nesappan 1 , padma ariga 2

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“…The fibula exhibits reasonable resistance to peri-implant resorption [11]. The bone stock has adequate strength to withstand reasonable forces of mastication [10,11].…”

Section: Case -1mentioning

confidence: 99%

Free fibula flap in the reconstruction of mandible: a report of six cases

Rao

Aditya

Gopinath

et al. 2009

J. Maxillofac. Oral Surg.

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The defects secondary to surgical ablation of the mandible have far reaching consequences. Speech, respiration, mastication, deglutition and cosmesis are severely affected. Restoring these functions is a challenging task. Till the late eighties, myocutaneous flaps were the rule for mandibular reconstruction and free bone was used to restore bony continuity. In spite of the result being predictable the outcome left much to be desired. There was also a fairly regular crop of complications. Acceptable dental rehabilitation was almost non-existent. With the introduction of free flaps as a consequence of the development of the operating microscope, the field of reconstruction was revolutionized. The fibular free flap is especially suited for mandibular reconstruction. It provides adequate bone to re-establish bony continuity and also allows for the placement of osseointegrated implants. Here we present six of our cases, which underwent mandibular reconstruction with free fibula flaps and the current thoughts in literature on the reconstruction of the mandible with this technique.

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Clinical outcome of dental implants placed in fibula‐free flaps used for the reconstruction of maxillo‐mandibular defects following ablation for tumors or osteoradionecrosis

Cited by 212 publications

References 43 publications

Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps

Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps

Comparison of Stresses Around Dental Implants Placed in Normal and Fibula Reconstructed Mandibular Models using Finite Element Analysis

Free fibula flap in the reconstruction of mandible: a report of six cases

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