Review Article

Assessing the survival rate of implants placed in vascularized and nonvascularized bone grafts for extensive jaw reconstructions in 2010 to 2021 articles: A review


Introduction: Restoring oral function with dental implants after maxillofacial defects improves aesthetics and provides adequate nutrition to improve patients’ quality of life significantly. One of the essential methods of repairing jawbone defects is bone grafting. Graft sources may be vascularized or nonsecularized. The present study aimed to review the survival rate of implants placed in vascularized and nonvascularized bone grafts for extensive jaw reconstructions in 2010 to 2021 articles. Materials and Methods: This study is a narrative review study. In this study, research published in PubMed, Google Scholar, and Scapus databases has been reviewed by a review method and with a keyword search strategy. Results: 2815 articles were found from the mentioned databases that after removing unrelated research (2713 cases) and duplicate researches (63 cases), 39 articles remained for final review. Then, those research that were presented in the scientific conference and were in the form of abstracts or did not have a correct statistical population, were excluded from the study (18 cases) and finally 21 articles were reviewed. Conclusion: Bone jaw defects are a severe complication that affects many aspects of a person’s life. Our results showed that vascularized and nonvascularized grafts are used for mandibular and maxillary bone regeneration. Also, after maxillary reconstruction, implant survival in vascularized and nonvascularized grafts was more than 90% in the 17 cases of 21 studied articles. Also, the duration of follow-ups was from 3 months to 14 years. Interestingly, in patients with head and neck cancer whose jaws were reconstructed with bone grafts and implants were placed in them, the survival rate of implants under radiotherapy was lower than in patients without radiotherapy.
[1] Cuesta-Gil M, Caicoya SO, Riba-García F, Ruiz BD, Cuéllar CN, Vila CN. Oral rehabilitation with osseointegrated implants in oncologic patients.Journal of oral and maxillofacial surgery. 2009; 67(11):2485-96.
[2] González-García R, Naval-Gías L, Rodríguez-CampoFJ, Muñoz-Guerra MF, Sastre-Pérez J. Vascularized free fibular flap for the reconstruction of mandibular defects: clinical experience in 42cases. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2008;106(2):191-202.
[3] Teoh KH, Huryn JM, Patel S, Halpern J, Tunick S, Wong HB, et al. Implant prosthodontic rehabilitation of fibula free-flap reconstructed mandibles: aMemorial Sloan-Kettering Cancer Center review of prognostic factors and implant outcomes. International Journal of Oral & Maxillofacial Implants.2005; 20(5).
[4] Nguyen TTH, Eo MY, Kuk TS, Myoung H, Kim SM. Rehabilitation of atrophic jaw using iliac onlay bone graft combined with dental implants. Int J Implant Dent. 2019; 5(1):11.
[5] Moraschini V, Poubel LdC, Ferreira V, dos Sp Barboza E. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. International journal of oral and maxillofacial surgery. 2015; 44(3):377-88.
[6] Morand M, Irinakis T. The challenge of implant therapy in the posterior maxilla: providing a rationale for the use of short implants. Journal of Oral Implantology. 2007; 33(5):257-66.
[7] Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clinical oral implants research. 2006; 17(S2):136-59.
[8] Aloy-Prósper A, Peñarrocha-Oltra D, Peñarrocha-Diago MA, Peñarrocha-Diago M. The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: a systematic review. Medicina oral, patologia oral y cirugia bucal.2015; 20(2):e251.
[9] Clementini M, Morlupi A, Agrestini C, Ottria L. Success rate of dental implants inserted in autologous bone graft regenerated areas: a systematic review. ORAL & implantology. 2011; 4(3-4):3.
[10] Clementini M, Morlupi A, Canullo L, Agrestini C, Barlattani A. Success rate of dental implants inserted in horizontal and vertical guided bone regenerated areas: a systematic review. International journal of oral and maxillofacial surgery. 2012;41(7):847-52.
[11] Quaranta A, Perrotti V, Piattelli A, Piemontese M, Procaccini M. Implants placed in sites of previously failed implants: a systematic review. Implantdentistry. 2014; 23(3):311-8.
[12] Lizio G, Corinaldesi G, Pieri F, Marchetti C. Problems with dental implants that were placed on vertically distracted fibular free flaps after resection: a report of six cases. British Journal of Oral and Maxillofacial Surgery. 2009; 47(6):455-60.
[13] Acocella A, Bertolai R, Colafranceschi M, Sacco R. Clinical, histological and histomorphometric evaluation of the healing of mandibular ramus bone block grafts for alveolar ridge augmentation before implant placement. J CraniomaxillofacSurg. 2010; 38(3):222-30.
[14] Pelo S, Boniello R, Moro A, Gasparini G, Amoroso PF. Augmentation of the atrophic edentulous mandible by a bilateral two-step osteotomy with autogenous bone graft to place osseointegrated dental implants. International Journal of Oral and Maxillofacial Surgery. 2010; 39(3):227-34.
[15] Chiapasco M, Romeo E, Coggiola A, Brusati R. Long-term outcome of dental implants placed in revascularized fibula free flaps used for the reconstruction of maxillo-mandibular defects due to extreme atrophy. Clin Oral Implants Res. 2011; 22(1):83-91.
[16] Parbo N, Murra NT, Andersen K, Buhl J, Kiil B, Nørholt SE. Outcome of partial mandibular reconstruction with fibula grafts and implant-supported prostheses. International Journal of Oral and Maxillofacial Surgery. 2013; 42(11):1403-8.
[17]Dottore AM, Kawakami PY, Bechara K, Rodrigues JA, Cassoni A, Figueiredo LC, et al. Stability of Implants Placed in Augmented Posterior Mandible after Alveolar Osteotomy Using Resorbable Nonceramic Hydroxyapatite or Intraoral Autogenous Bone: 12-Month Follow-Up. Clinical Implant Dentistry and Related Research. 2014;16(3):330-6.
[18] Fenlon MR, Lyons A, Farrell S, Bavisha K, Banerjee A, Palmer RM. Factors affecting survival and usefulness of implants placed in vascularized free composite grafts used in post-head and neck cancer reconstruction. Clin Implant Dent Relat Res. 2012; 14(2):266-72.
[19] Kim A, Kar K, Nowzari H, Cha H-S, Ahn K-M.Immediate Free Iliac Bone Graft After Nonsegmental Mandibular Resection and Delayed Implant Placement: A Case Series. Implant Dentistry. 2013; 22(5).
[20]Acobsen C, Kruse A, Lübbers HT, Zwahlen R, Studer S, Zemann W, et al. Is mandibular reconstruction using vascularized fibula flaps and dental implants a reasonable treatment? Clinical implant dentistry and related research. 2014; 16(3):419-28.
[21] De Moraes PH, Olate S, Lauria A, Asprino L, de Moraes M, de Albergaria-Barbosa JR. 8-10 year follow-up survival of dental implants in maxillae with or without autogenous bone graft reconstruction.Int J Clin Exp Med.2015; 8(10):19282-9.
[22] Hakim SG, Kimmerle H, Trenkle T, Sieg P, Jacobsen HC. Masticatory rehabilitation following upper and lower jaw reconstruction using vascularized free fibula flap and enossal implants-19 years of experience with a comprehensive concept. ClinOral Investig. 2015; 19(2):525-34.
[23] Rahim I, Salt S, Heliotis M. Successful long-term mandibular reconstruction and rehabilitation using nonvascularised autologous bone graft and recombinant human BMP-7 with subsequent endosseous implant in a patient with bisphosphonate-related osteonecrosis of the jaw. British Journal of Oral and Maxillofacial Surgery.2015;53(9):870-4.
[24] Kang Y-H, Kim H-M, Byun J-H, Kim U-K, Sung I-Y, Cho Y-C, et al. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone. BMC Oral Health.2015; 15(1):172.
[25] Bllaca F, Toci E. Dental Implantation of Atrophic Jaws Reconstructed with Iliac Bone Graft Crest – Outcome of Seven Cases. Open Access Maced JMed Sci. 2016; 4(4):709-13.
[26] Schwartz-Arad D, Ofec R, Eliyahu G, Ruban A,Sterer N. Long Term Follow-Up of Dental Implants Placed in Autologous Onlay Bone Graft.Clinical Implant Dentistry and Related Research.2016; 18(3):449-61.
[27] Sozzi D, Novelli G, Silva R, Connelly ST, Tartaglia GM. Implant rehabilitation in fibula-free flap reconstruction: A retrospective study of cases at 1-18 years following surgery. J Craniomaxillofac Surg. 2017; 45(10):1655-61.
[28] Gurler G, Delilbasi C, Garip H, Tufekcioglu S.Comparison of alveolar ridge splitting and autogenous onlay bone grafting to enable implant placement in patients with atrophic jaw bones.Saudi Med J. 2017; 38(12):1207-12.
[29] Doimi JR, Balseca GMA, Torre ACL. Placement of dental implants in atrophic jaw with divided crest and ridge expansion technique. Revista Odontológica Mexicana. 2017; 21(3):e192-e8.
[30] Khachatryan L, Khachatryan G, Hakobyan G. The Treatment of Lower Jaw Defects Using Vascularized Fibula Graft and Dental Implants. Journal of Craniofacial Surgery. 2018; 29(8).
[31] Attia S, Wiltfang J, Pons-Kühnemann J, Wilbrand J-F, Streckbein P, Kähling C, et al. Survival of dental implants placed in vascularised fibula free flaps after jaw reconstruction. Journal of Cranio-Maxillofacial Surgery.2018; 46(8):1205-10.
[32]Karimi A, Rad KA, Sadeghi HMM, Hasheminasab M. Survival rate and cervical bone loss of implants placed in non vascularized iliac graft after segmental mandibulectomy. Journal of Craniomaxillofacial Research. 2019:60-5.
[33] Kuriakose MA, Shnayder Y, DeLacure MD. Reconstruction of segmental mandibular defects by distraction osteogenesis for mandibular reconstruction. Head & Neck: Journal for the Sciences and Specialties of the Head and Neck. 2003;25(10):816-24.
[34] Yoo J, Dowthwaite SA, Fung K, Franklin J, Nichols A. A new angle to mandibular reconstruction:the scapular tip free flap. Head & neck. 2013;35(7):980-6.
[35] Cordeiro PG, Disa JJ, Hidalgo DA, Hu QY. Reconstruction of the mandible with osseous free flaps: a 10- year experience with 150 consecutive patients. Plastic and reconstructive surgery. 1999;104(5):1314-20.
[36]Disa JJ, Cordeiro PG, editors. Mandible reconstruction with microvascular surgery. Seminars in surgical oncology; 2000: Wiley Online Library.
[37]Schliephake H, Schmelzeisen R, Husstedt H,Schmidt-Wondera L-U. Comparison of the late results of mandibular reconstruction using nonvascularized or vascularized grafts and dental implants.ournal of oral and maxillofacial surgery.1999; 57(8):944-50.
[38] Zou D, Huang W, Wang F, Wang S, Zhang Z,Zhang C, et al. Autologous I lium Grafts: Long-Term Results on Immediate or Staged Functional Rehabilitation of Mandibular Segmental Defects Using Dental Implants after Tumor Resection.Clinical implant dentistry and related research.2015; 17(4):779-89.
[39]Buser D, Mericske-stern R, Pierre Bernard JP,Behneke A, Behneke N, Hirt HP, et al. Longterm evaluation of non-submerged ITI implants.Part 1: 8-year life table analysis of a prospectivemulti-center study with 2359 implants. Clinical oral implants research. 1997; 8(3):161-72.
[40] Tonetti MS, Schmid J. Pathogenesis of implant failures. Periodontol 2000. 1994; 4:127-38.
[41] Albrektsson, T., Brånemark, P. I., Hansson, H. A.,& Lindström, J. (1981). Osseointegrated titanium implants: requirements for ensuring a long-lasting,direct bone-to-implant anchorage in man.Acta Orthopaedica Scandinavica, 52(2), 155-170.
[42] Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clinical oral implants research. 2006; 17(S2):35-51.
[43] Borie E, Orsi IA, de Araujo CP. The influence of the connection, length and diameter of an implant on bone biomechanics. Acta Odontologica Scandinavica.2015; 73(5):321-9.
[44] Arsalanloo Z, Telchi R, Osgouie KG. Optimum selection of the dental implants according to length and diameter parameters by FE method in the anterior position. International Journal of Bioscience,Biochemistry and Bioinformatics. 2014;4(4):265.
[45] Busenlechner D, Fürhauser R, Haas R, Watzek G,Mailath G, Pommer B. Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis. Journal of periodontal implant science.2014; 44(3):102-8.
[46]Bataineh AB, Al-Dakes AM. The influence of length of implant on primary stability: an in vitro study using resonance frequency analysis. Journal of clinical and experimental dentistry. 2017;9(1):e1.
[47] Yeşildal R. Effect of implant diameter and length on stress distribution for titanium and zirconia implants by using finite element analysis (FEA).Open Access Library Journal. 2015; 2(01):1.
[48] Abraham HM, Philip JM, Jain AR, Venkatakrishnan C. The effect of implant and abutment diameter on periimplant bone stress: A three-dimensionalfinite element analysis. Journal of Oral Research and Review. 2016; 8(2):49.
[49]Topkaya T, Solmaz M, Dündar S, Eltas A. Numerical analysis of the effect of implant geometry to stress distributions of dental implant system.Cumhuriyet Dental Journal. 2014; 18(1):17-24.
[50] Wang F, Zhang Z, Monje A, Huang W, Wu Y, Wang G. Intermediate long-term clinical performance of dental implants placed in sites with a previous early implant failure: a retrospective analysis. Clinical oral implants research. 2015; 26(12):1443-9.
[51] Termeie D, Klokkevold PR, Caputo AA. Effect of implant diameter and ridge dimension on stress distribution in mandibular first molar sites—A photoelastic study. Journal of Oral Implantology.2015; 41(5):e165-e73.
[52] Shigehara S, Ohba S, Nakashima K, Takanashi Y,Asahina I. Immediate loading of dental implants inserted in edentulous maxillas and mandibles:5-year results of a clinical study. Journal 53] French D, Larjava H, Ofec R. Retrospective cohort study of 4591 Straumann implants in privatepractice setting, with up to 10-year follow-up. Part1: multivariate survival analysis. Clinical oral implants research.2015; 26(11):1345-54.
[54] 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.Journal of clinical periodontology. 2002; 29:226-31.
[55] Wu Y-q, Huang W, Zhang Z-y, Zhang Z-y, Zhang C-p, Jian S. Clinical outcome of dental implantsplaced in fibula-free flaps for orofacial reconstruction.Chinese medical journal. 2008; 121(19):1861-5.
[56] 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. Clinical oral implants research. 2006; 17(2):220-8.
[57] Kumar VV, Ebenezer S, Kämmerer PW, Jacob P, Kuriakose MA, Hedne N, et al. Implants in free fibula flap supporting dental rehabilitation–Implant and peri-implant related outcomes of a randomizedclinical trial. Journal of Cranio-Maxillofacial Surgery. 2016; 44(11):1849-58.
[58] Lanzer M, Gander T, Grätz K, Rostetter C, Zweifel D, Bredell M. Scapular free vascularised bone flaps for mandibular reconstruction: are dental implants possible? Journal of oral & maxillofacial research. 2015; 6(3).
[59] Li Y, Ling J, Jiang Q. Inflammasomes in AlveolarBone Loss. 2021; 12(2130).
IssueVol 9, No 2 (Spring 2022) QRcode
SectionReview Article(s)
Mandibular atrophy Atrophic maxilla Vascularized graft Nonvascularized graft Implant survival

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Razmara F, Bolandparva F, Mohammadi S. Assessing the survival rate of implants placed in vascularized and nonvascularized bone grafts for extensive jaw reconstructions in 2010 to 2021 articles: A review. J Craniomaxillofac Res. 2022;9(2):57-68.