Survival rate and cervical bone loss of implants placed in non vascularized iliac graft after segmental mandibulectomy
Abstract
Objective: The purpose of this study was to evaluate the survival rate and the amount of periimplant bone loss in implants placed in free iliac graft following segmental mandible resection. Materials and Methods: Over a 5-year period between 2010 and 2015, nine patients with odontogenic tumors who were candidate for segmental mandible resection were enrolled in this study. Resection defect was immediately reconstructed with non-vascularized iliac graft and 4-6 months later 36 implants of 5 different brands were inserted in grafted mandibles. Information regarding implant survival, peri implant bone loss or inflammation for a mean follow up period of 33 months was obtained. Results: One implant was failed out of 36 implants and the cumulative survival rate of implants was 97.2% in this follow up period. There was no sign of peri implant inflammation or gingival recession or BOP in any patients. The cervical bone loss level varied between 0.6 to 12mm (the length of failed implant) with the average of 0.96 mm. The bone loss level of survived implants varied between 0.6to 1.72mm with average of 0.64mm. Conclusion: This study demonstrated that reconstruction of segmental mandibular defect with non vascularized iliac graft followed by dental implant placement is an effective and predictable method to restore oral function. Keywords: Implant; Non vascularized iliac graft; Segmental resection; Survival; Cervical bone loss.
1. Carneiro TAPN, Oliveira MTF, Lima LB, Simamoto-Junior PC, Zanetta-Barbosa D.Immediate loaded implant-supported prosthesis after mandibular reconstruction with free iliac crest bone graft. Rev Port Estomatol Med Dent Cir Maxilofac. 2015; 56:117-121.
2. Young CW, Pogrel MA, Schmidt BL. Quality of life in patients undergoing segmental mandibular resection and staged reconstruction with nonvascularized bone grafts. J Oral Maxillofac Surg. 2007 Apr; 65(4):706-12.
3. Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A. Autogenous bone grafts in oral implantology-is it still a "gold standard"? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent. 2017 Dec; 3(1):23. doi: 10.1186/s40729-017-0084-4. Epub 2017 Jun 1.
4. Pogrel MA, Podlesh S, Anthony JP,Alexander J.: A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofacial Surg,1997;55:1200.
5. Kademani D, Keller E: Iliac crest grafting for mandibular reconstruction. Atlas Oral Maxillofacial Surg N Am,2006, 14:161.
6. Van Gemert JT, van Es RJ, Van Cann EM, Koole R. Nonvascularized bone grafts for segmental reconstruction of the mandible--a reappraisal. J Oral Maxillofac Surg. 2009 Jul; 67(7):1446-52. doi: 10.1016/j.joms.2008.12.052.
7. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J OralMaxillofac Implants 1986; 1:11–25.
8. Kuriakose MA, Shnayder Y, DeLacure MD. Reconstruction of segmental mandibular defects by distraction osteogenesis for mandibular reconstruction. Head Neck. 2003 Oct; 25(10):816-24.
9. Yoo J, Dowthwaite SA, Fung K, Franklin J, Nichols A. A new angle to mandibular reconstruction: the scapular tip free flap. Head Neck. 2013 Jul; 35(7):980-6. doi: 10.1002/hed.23065. Epub 2012 Jul 30.
10. Cordeiro P G, Disa J J, Hidalgo D A, Hu Q Y. Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg. 1999; 104:1314–1320.
11. Disa JJ, Cordeiro PG. Mandible reconstruction with microvascular surgery. Semin Surg Oncol. 2000; 19:226–234.
12. Schliephake H, Schmelzeisen R, Husstedt H, Schmidt-Wondera LU. Comparison of the late results of mandibular reconstruction using nonvascularized or vascularized grafts and dental implants. J Oral Maxillofac Surg.1999; 57:944–950.
13. Zou D, Huang W, Wang F, Wang S, Zhang Z, Zhang C, Kaigler D, Wu Y . Autologous Ilium Grafts: Long-Term Results on Immediate or Staged Functional Rehabilitation of Mandibular Segmental Defects Using Dental Implants after Tumor Resection. Clin Implant Dent Relat Res. 2015 Aug; 17(4):779-89. doi: 10.1111/cid.12169. Epub 2013 Oct 31.
14. Kim A, Kar K, Nowzari H, Cha HS, Ahn KM. Immediate free iliac bone graft after nonsegmental mandibular resection and delayed implantplacement: a case series. Implant Dent. 2013 Oct; 22(5):438-43. doi: 10.1097/ID.0b013e31829f1ed0.
15. Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res. 2012 Oct; 23 Suppl 6:22-38. doi: 10.1111/j.1600-0501.2012.02546.x
16. Hämmerle CH, Jung RE, Feloutzis A. A systematic review of the survival of implants in bone sites augmented with barrier membranes (guided bone regeneration) in partially edentulous patients. J Clin Periodontol. 2002; 29 Suppl 3:226-31; discussion 232-3.
17. Chiapasco M, Biglioli F, Autelitano L, Romeo E, Brusati R. Clinical outcome of dental implants placed in fibula-free flaps used for the reconstruction of maxillo-mandibular defects following ablation for tumors or osteoradionecrosis. Clin Oral Implants Res. 2006 Apr; 17(2):220-8.
18. Kumar VV, Ebenezer S, Kämmerer PW, Jacob PC, Kuriakose MA, Hedne N, Wagner W, Al-Nawas B. Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial. J Craniomaxillofac Surg. 2016, Nov;44(11):1849-1858. doi: 10.1016/j.jcms.2016.08.023. Epub 2016 Sep 9.
19. Wu YQ, Huang W, Zhang ZY, Zhang ZY, Zhang CP, Sun J. Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction. Chin Med J (Engl). 2008, Oct 5;121(19):1861-5.
20. Lanzer M, Gander T, Grätz K, Rostetter C, Zweifel D, Bredell M. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible? J Oral Maxillofac Res. 2015, Jun 30;6(3):e4. doi: 0.5037/jomr.2015.6304. eCollection 2015 Jul-Sep.
2. Young CW, Pogrel MA, Schmidt BL. Quality of life in patients undergoing segmental mandibular resection and staged reconstruction with nonvascularized bone grafts. J Oral Maxillofac Surg. 2007 Apr; 65(4):706-12.
3. Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A. Autogenous bone grafts in oral implantology-is it still a "gold standard"? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent. 2017 Dec; 3(1):23. doi: 10.1186/s40729-017-0084-4. Epub 2017 Jun 1.
4. Pogrel MA, Podlesh S, Anthony JP,Alexander J.: A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofacial Surg,1997;55:1200.
5. Kademani D, Keller E: Iliac crest grafting for mandibular reconstruction. Atlas Oral Maxillofacial Surg N Am,2006, 14:161.
6. Van Gemert JT, van Es RJ, Van Cann EM, Koole R. Nonvascularized bone grafts for segmental reconstruction of the mandible--a reappraisal. J Oral Maxillofac Surg. 2009 Jul; 67(7):1446-52. doi: 10.1016/j.joms.2008.12.052.
7. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J OralMaxillofac Implants 1986; 1:11–25.
8. Kuriakose MA, Shnayder Y, DeLacure MD. Reconstruction of segmental mandibular defects by distraction osteogenesis for mandibular reconstruction. Head Neck. 2003 Oct; 25(10):816-24.
9. Yoo J, Dowthwaite SA, Fung K, Franklin J, Nichols A. A new angle to mandibular reconstruction: the scapular tip free flap. Head Neck. 2013 Jul; 35(7):980-6. doi: 10.1002/hed.23065. Epub 2012 Jul 30.
10. Cordeiro P G, Disa J J, Hidalgo D A, Hu Q Y. Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg. 1999; 104:1314–1320.
11. Disa JJ, Cordeiro PG. Mandible reconstruction with microvascular surgery. Semin Surg Oncol. 2000; 19:226–234.
12. Schliephake H, Schmelzeisen R, Husstedt H, Schmidt-Wondera LU. Comparison of the late results of mandibular reconstruction using nonvascularized or vascularized grafts and dental implants. J Oral Maxillofac Surg.1999; 57:944–950.
13. Zou D, Huang W, Wang F, Wang S, Zhang Z, Zhang C, Kaigler D, Wu Y . Autologous Ilium Grafts: Long-Term Results on Immediate or Staged Functional Rehabilitation of Mandibular Segmental Defects Using Dental Implants after Tumor Resection. Clin Implant Dent Relat Res. 2015 Aug; 17(4):779-89. doi: 10.1111/cid.12169. Epub 2013 Oct 31.
14. Kim A, Kar K, Nowzari H, Cha HS, Ahn KM. Immediate free iliac bone graft after nonsegmental mandibular resection and delayed implantplacement: a case series. Implant Dent. 2013 Oct; 22(5):438-43. doi: 10.1097/ID.0b013e31829f1ed0.
15. Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res. 2012 Oct; 23 Suppl 6:22-38. doi: 10.1111/j.1600-0501.2012.02546.x
16. Hämmerle CH, Jung RE, Feloutzis A. A systematic review of the survival of implants in bone sites augmented with barrier membranes (guided bone regeneration) in partially edentulous patients. J Clin Periodontol. 2002; 29 Suppl 3:226-31; discussion 232-3.
17. Chiapasco M, Biglioli F, Autelitano L, Romeo E, Brusati R. Clinical outcome of dental implants placed in fibula-free flaps used for the reconstruction of maxillo-mandibular defects following ablation for tumors or osteoradionecrosis. Clin Oral Implants Res. 2006 Apr; 17(2):220-8.
18. Kumar VV, Ebenezer S, Kämmerer PW, Jacob PC, Kuriakose MA, Hedne N, Wagner W, Al-Nawas B. Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial. J Craniomaxillofac Surg. 2016, Nov;44(11):1849-1858. doi: 10.1016/j.jcms.2016.08.023. Epub 2016 Sep 9.
19. Wu YQ, Huang W, Zhang ZY, Zhang ZY, Zhang CP, Sun J. Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction. Chin Med J (Engl). 2008, Oct 5;121(19):1861-5.
20. Lanzer M, Gander T, Grätz K, Rostetter C, Zweifel D, Bredell M. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible? J Oral Maxillofac Res. 2015, Jun 30;6(3):e4. doi: 0.5037/jomr.2015.6304. eCollection 2015 Jul-Sep.
| Files | ||
| Issue | Vol 6, No 2 (Spring 2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v6i2.2264 | |
| Keywords | ||
| Implant; Non vascularized iliac graft; Segmental resection; Survival; Cervical bone loss. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Karimi A, Arian Rad K, Mir Mohammad Sadeghi H, Hasheminasab M. Survival rate and cervical bone loss of implants placed in non vascularized iliac graft after segmental mandibulectomy. J Craniomaxillofac Res. 2019;6(2):60-65.
