Vascularized Scapular Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Winocour, Sebastian; Xue, Erica Y; Bohl, Michael A.; Farrokhi, Farrokh; Davis, Matthew J.; Abu‐Ghname, Amjed; Ropper, Alexander E.; Reece, Edward M.

doi:10.1055/s-0041-1723833

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…The reconstruction of oral and maxillofacial (OMF) defects secondary to tumor, osteonecrosis, trauma, and congenital disease represent a daunting task in head and neck surgery and require a multidisciplinary treatment approach. To this end, vascularized bone flaps serve as the gold standard for OMF reconstruction, which commonly includes, vascularized fibula flap (VFF), deep circumflex iliac artery flap (DCIA), and vascularized osteomyocutaneous scapular flap (VOSF) [1][2][3]. These flaps benefit from an adequate blood supply, sufficient bone mass and satisfactory flap survival rate [4].…”

Section: Introductionmentioning

confidence: 99%

Long-term survival of implant-based oral rehabilitation following maxillofacial reconstruction with vascularized bone flap

Dessel

Shujaat

et al. 2022

Int J Implant Dent

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Aim The aim of the study was to assess the 5-year cumulative survival rate of implant-based dental rehabilitation following maxillofacial reconstruction with a vascularized bone flap and to investigate the potential risk factors which might influence the survival rate. Materials and methods A retrospective cohort study was designed. Inclusion criteria involved 18 years old or above patients with the availability of clinical and radiological data and a minimum follow-up 1 year following implant placement. The cumulative survival rate was analyzed by Kaplan–Meier curves and the influential risk factors were assessed using univariate log-rank tests and multivariable Cox-regression analysis. Results 151 implants were assessed in 40 patients with a mean age of 56.43 ± 15.28 years at the time of implantation. The mean number of implants placed per patient was 3.8 ± 1.3 with a follow-up period of 50.0 ± 32.0 months. The cumulative survival at 1-, 2- and 5-years was 96%, 87%, and 81%. Patients with systemic diseases (HR = 3.75, 95% CI 1.65–8.52; p = 0.002), irradiated flap (HR = 2.27, 95% CI 1.00–5.17; p = 0.05) and poor oral hygiene (HR = 11.67; 95% CI 4.56–29.88; p < 0.0001) were at a significantly higher risk of implant failure. Conclusion The cumulative implant survival rate was highest at 1st year followed by 2nd and 5th year, indicating that the risk of implant failure increased over time. Risk indicators that seem to be detrimental to long-term survival include poor oral hygiene, irradiated flap and systemic diseases.

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