Osseointegrated implants into a variety of composite free flaps: A comparative analysis

Burgess, Michael A.; Leung, Mason C.P.; Chellapah, Anthony; Clark, Jonathan; Batstone, Martin

doi:10.1002/hed.24609

Cited by 61 publications

(64 citation statements)

References 18 publications

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“…Ideally mandibular reconstruction should be accompanied by immediate or delay dental implantation to optimize mastication, being the ultimate goal in oromandibular reconstruction. FFFs had historically shown more reliability for osseointegrated implantation, with a superior bone stock (Burgess, Leung, Chellapah, Clark, & Batstone, ); however, multiple investigators have demonstrated that scapular system flaps are implantable (Tang, Bearelly, & Mannion, ). Many head and neck cancer patients are poor candidates for dental implantation due to radiotherapy, poor dental hygiene, lower socioeconomic status, and trismus (Dholam, Pusalkar, Yadav, Quazi, & Somani, ) among other factors resulting in a very small portion of our population being rehabilitated.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictors of plate extrusion in oromandibular free flap reconstruction

et al. 2018

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At our institution, use of the STFF predicts mandibular defects that are less prone to developing plate extrusion and FFF tended to be used more frequently in anterior defects with osteotomies. However, after controlling for these factors use of the FFF appeared to have higher rates of extrusion than scapular flaps. Further prospective studies controlling for defect variables are needed to elucidate the risk factors for plate extrusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of plate extrusion in oromandibular free flap reconstruction

et al. 2018

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“…Many retrospective clinical studies have supported this hypothesis, [10][11][12] whereas others have shown no statistical difference in implant survival between irradiated and nonirradiated bone. 2,13,14 In this study, we aimed to report the success rate of both dental and craniofacial osseointegrated implants in patients with head and neck cancer. Furthermore, we aimed to define the impact of radiotherapy, smoking, and chemotherapy on the success and failure of these implants.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of dental and craniofacial osseointegrated implantation in head and neck cancer patients

et al. 2019

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Background Treatment of head and neck cancer may result in disfiguring and debilitating anatomical changes. Osseointegrated implants may be used in these patients to facilitate attachment of implant‐retained dentures or cosmetic prostheses. Methods A retrospective audit was performed, reviewing the treatment of patients who received dental or craniofacial osseointegrated implants during treatment of head and neck cancer. Results One hundred sixty implants were inserted in 54 patients with oral, nasal, orbital, or auricular defects. Overall, 85% of implants were successful after mean follow‐up of 25.7 months. The brand of implant used was shown to impart a statistically significant implant survival difference, and orbital implants had poorer survival compared to nonorbital implants. There was a statistical insignificant implant survival advantage in both nonsmokers and patients who did not undergo radiotherapy. Conclusions Dental and craniofacial osseointegrated implants may be reliably used in patients with head and neck cancer. However, further research is required to clarify the role of smoking in osseointegrated implant failure.

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“…Placement of the bone in a position that is not suitable for dental rehabilitation is an all too frequent outcome, if some basic principles are not followed. Previous research in this area has focussed on osseointegration into the fibula free flap which is the most widely used donor site for mandibular reconstruction but all osseous free flaps of sufficient bone volume are capable of highly reliable osseointegration (Fig. ).…”

Section: Contemporary Practicementioning

confidence: 99%

“…). Predictable long term prosthetic success is achievable, although there are many studies which demonstrate the impaired survival of osseointegrated implants in the irradiated patient . In addition, as the implant must pass through skin or altered mucosa rather than normal gingiva peri‐implant mucositis and peri‐implantitis are challenges for all the rehabilitation team to manage.…”

Section: Contemporary Practicementioning

confidence: 99%

Reconstruction of major defects of the jaws

Batstone

2018

Australian Dental Journal

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Prosthetic replacements in the 19th and early 20th century were superseded by pedicled flaps and obturators. These have subsequently been superseded by free tissue transfer which currently is the mainstay of reconstructive jaw surgery. Although malignant and benign processes of the jaws are the predominant cause of segmental defects, a significant proportion still occurs due to trauma, or even iatrogenic causes such as radiotherapy. The varied aetiologies demand a nuanced approach to reconstruction and although the techniques remain similar the timing can be quite different. The maxilla and the mandible are both amenable to composite reconstruction with bone. The fibula, iliac crest, scapula, distal radius and medial femoral condyle are the most commonly utilised donor sites for vascularised reconstruction. Each has strengths and weaknesses and the requirements of the defect, and patient preference should outweigh surgeon preference. Osseointegrated implants allow reliable rehabilitation of the dentition by anchoring facial prostheses. Their integration into composite flaps is highly reliable although soft tissue management can be challenging. Virtual surgical planning and 3D printing have already impacted on the surgical workflow and improved the reliability and accuracy of results. If this technology can be applied to tissue typing and human tissue (instead of just plastic and metal) a fully prefabricated and vascularised jaw without donor site morbidity would be the ultimate aim.

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Osseointegrated implants into a variety of composite free flaps: A comparative analysis

Abstract: Implants placed into VBGs have a reasonable success rate in well-selected patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 443-447, 2017.

Cited by 61 publications

References 18 publications

Predictors of plate extrusion in oromandibular free flap reconstruction

Predictors of plate extrusion in oromandibular free flap reconstruction

Outcomes of dental and craniofacial osseointegrated implantation in head and neck cancer patients

Reconstruction of major defects of the jaws

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