Continuity defects in bone after resection of the jaw may cause problems, and osseo-myocutaneous free flaps are the gold standard for their reconstruction. Implant-supported prosthetic rehabilitation is reliable with these microvascular options, although it is still a serious challenge. The aim of this prospective clinical study was to describe the advantages of implants restored according to a computer-assisted surgical protocol. A group of 10 consecutive patients (both sexes) had already been treated and followed up for at least 1 year after prosthetic loading. The NobelGuide protocol had to be modified to adapt the technique for these patients who had had reconstructions. A total of 56 fixtures were installed and, when possible, immediately loaded (overall survival of implants 95%). Every patient was given correct provisional prosthetic rehabilitation, which was most satisfactory as far as chewing, social functioning, and overall quality of life were concerned. Three-dimensional computed tomographic (CT) examination showed a mean (SD) marginal bone loss of 1.06 (0.5) mm. We used a modified technique of computer-assisted implant surgery in jaws that had been reconstructed with free flaps; from these preliminary findings this approach seems valid when it comes to function, improving prosthetic restoration, and aesthetics.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to British Journal of Oral and Maxillofacial Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Titanium miniplate fixation in free flap mandible reconstruction.Ann Plast Surg. 1989; 23: 498-507
- Reconstruction of mandible by free fibular flap.J Coll Physicians Surg Pak. 2010; 20: 723-727
- 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 Implant Res. 2006; 17: 220-228
- Oral rehabilitation with endosteal implants and free flaps. Int J Oral Maxillofac Surg 1996;25:3–12.Int J Oral Maxillofac Surg. 1996; 25: 248
- Computed tomography-guided implant surgery for dental rehabilitation in mandible reconstructed with a fibular free flap: description of the technique.Br J Oral Maxillofac Surg. 2012; 50: 30-35
- Behavior of implants in bone grafts or free flaps after tumor resection.Clin Oral Implants Res. 2000; 11: 66-75
- The use of computer-guided flapless implant surgery and four implants placed in immediate function to support a fixed denture: preliminary results after a mean follow-up period of thirteen months J Prosthet Dent 2008;97 (6 Suppl.):s26–34.J Prosthet Dent. 2008; 99: 167
- Implant treatment software planning and guided flapless surgery with immediate provisional prosthesis delivery of the fully edentulous maxilla A retrospective analysis of 15 consecutively treated patients.Eur J Oral Implantol. 2010; 3: 245-251
- Reconstruction of maxillary and mandibular defects using prefabricated microvascular fibular grafts and osseointegrated dental implants—a prospective study.Clin Oral Implants Res. 2004; 15: 598-606
Published online: January 12, 2012
Accepted: December 13, 2011
© 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.