Hongyang Ma*1; Jeroen Van Dessel1; Sohaib Shujaat1; Yi Sun1; Michel Bila1; Constantinus Politis1; Reinhilde Jacobs1,2

1Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; 2Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden

Background: Dental implants have been increasingly used for prosthetic rehabilitation after oral and maxillofacial reconstruction by vascularized bone flaps. However, the survival rate and factors affecting the survival of osseointegrated dental implants are still to be further examined especially in the long term.

Aim/Hypothesis: This study aimed to evaluate the 5-years survival of dental implants and to identify potential risk factors in patients who underwent a maxillofacial reconstruction with a vascularized free flap.

Material and Methods: Forty patients (26 men and 14 women with a mean age of 56 years) with 151 implants were included. All patients had undergone a maxillofacial reconstruction with a vascularized free bone flap. The factors associated with implant survival or failure were identified over a follow-up period of 5 years. The distributions of implant survival were estimated by Kaplan-Meier curves and compared through log-rank tests. Cox proportional-hazard models were used to univariate/multivariate estimate the hazard ratio (HR) and calculate corresponding 95% confidence intervals (CI).

Results: The cumulative survival rate was 96% at 1 year, 87% at 2 years, and 81% at 5 years. The univariate analysis also illustrates other parameters at 1, 2, and 5-year time points. Age, gender, nicotine use, radiotherapy, etiology, defect site, flap type, flap complication, type of bone graft, and dental implant length and insertion stage did not show any influence on implant survival. However, systemic disease and oral hygiene were determined as significant factors influencing the survival rate.

Conclusion and Clinical implications: This study demonstrates that the survival rate of implants is significantly lower patients with a poor oral hygiene and systemic disease after maxillofacial reconstruction with free vascularized bone flap. The overall long-term survival (81%) of implants placed in the reconstructed area can assure an excellent prognosis of implant-supported prostheses irrespective of the treatment procedure.

Disclosure of Interest: None Declared.

Keywords: clinical studies/trials, dental implants, long term