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Factors Affecting Survival and Usefulness of Implants Placed in Vascularized Free Composite Grafts Used in Post–Head and Neck Cancer Reconstruction
Author(s) -
Fenlon Michael R.,
Lyons Andrew,
Farrell Suzanne,
Bavisha Kalpesh,
Banerjee Avijit,
Palmer Richard M.
Publication year - 2012
Publication title -
clinical implant dentistry and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.338
H-Index - 85
eISSN - 1708-8208
pISSN - 1523-0899
DOI - 10.1111/j.1708-8208.2009.00250.x
Subject(s) - medicine , osseointegration , implant , dentistry , survival rate , head and neck cancer , radiation therapy , surgery
Background: Bone‐containing vascularized grafts have been used successfully to reconstruct post‐cancer surgical defects. Dental implants can be placed in these bone‐containing grafts to allow implant‐supported prosthodontic reconstruction of these patients. Purpose: The aim of this study was to evaluate the survival of dental implants used in the rehabilitation of subjects treated with bone‐containing vascularized grafts to compare usability of implants placed at the time of reconstruction and after healing. Materials and Methods: A cross‐sectional study was undertaken to examine survival rates of implants placed in vascularized bone‐containing grafts either immediately at the time of surgical reconstruction or after 3 months healing. Other factors such as graft type, whether radiation therapy was given, and implant type were recorded. Results: A total of 41 patients had 145 implants placed in 47 vascularized bone‐containing flaps. Increased failure rate of implants was seen in immediately placed implants. There was also a significant increase in the number of osseointegrated implants that were prosthodontically unusable or sub‐optimally placed in the immediate placement group. Radiation therapy was associated with a significant increase in failure rate. Modern implant surfaces appeared to perform better than machined/turned surfaces. Graft donor site did not influence implant survival. Conclusion: This study demonstrated the difficulties encountered with immediate placement of dental implants at the time of post‐cancer reconstructive surgery.