Use of Porous Implants for the Prosthetic Rehabilitation of Fibula Free Flap Reconstructed Patients

Abstract

Vascularized free flaps represent today the gold standard in Maxillo-Facial reconstructive treatment of the upper and lower compromised maxillas. The aim of this study is to perform the advantages and disadvantages of the vascularized fibula free flap and the available rehabilitation options with porous implants. In this study the authors analyzed 45 patients with 211 inserted implants treated and reconstructed with vascularized fibula flaps. The authors compared the use of 103 titanium tapered implants (with micro rough surface) versus 108 tantalum-titanium porous implants to evaluate the bone reabsorption and implant survival. Immediate implant stability, the peri-implant reabsorption, and the survival were evaluated. The follow-up was after 3, 6, 12, and 24 months. The authors found that for the 108 Zimmer TM they had an average bone loss of 1 mm ± 0.2 mm after 1 year of follow-up, compared with the other implants where the average bone loss was 2.27 mm ± 0.4. This study demonstrated that the problems caused by different fibula flaps level, compared with the mandibula or, with adjacent teeth in the maxilla, can be solved using TM porous implants that almost duplicate the fixture surface and guarantees long life prognosis to the authors’ prosthetic devices.

Dental Implant Failure Risk in Post Oncological Patients, a Retrospective Study and Sapienza Head and Neck Unit Decisional Protocol- 7 Years of Follow-Up

“…Bone quality can be classified into four categories, based on its radiographic appearance and the resistance to drilling [ 43 ]: (1) “type 1 bone”, homogenous compact bone; (2) “type 2 bone”, dense trabecular bone surrounded by a thick cortical bone; (3) “type 3 bone”, in which a dense trabecular bone is surrounded by a thin layer of cortical bone; (4) “type 4 bone”, characterized by a core of low-density trabecular bone and a thin layer of cortical bone. Dental implants placed in grafted bone/free bone flaps bone can be considered as well performing as those placed in regular bone, as also described in the literature [ 44 , 45 , 46 ]. Figure 2 and Figure 3 present an example of free fibula flap (FFF) reconstruction and dental rehabilitation.…”

Dental Implants: Modern Materials and Methods of Their Surface Modification

“…However, tantalum has a number of disadvantages, such as the high cost of the material, and there are difficulties in manufacturing the precise internal relief of the implants, which also increases the cost of tantalum implants, so they are not available to all patients. As a consequence, the dental implant can be made in a hybrid design (titanium alloy anchoring base with a trabecular tantalum middle part) [30,234,244,245] and also form tantalum coatings on implants made of other materials [126,[246][247][248][249][250].…”

Head and Neck Osteosarcoma—The Ongoing Challenge about Reconstruction and Dental Rehabilitation

“…The results obtainable are better compared to the mobile prosthesis. [30,40]. The EORTC QLQ-H&N35 questionnaire [26], filled before and after dental rehabilitation, shows average values of QOL improvement after treatment.…”