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Comparative analysis of dental implant treatment outcomes following mandibular reconstruction with double-barrel fibula bone grafting or vertical distraction osteogenesis fibula: a retrospective study

Authors

  • Feng Wang,

    1. Department of Oral and Maxillofacial Implantology, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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    • These authors contributed equally to this work.
  • Wei Huang,

    1. Department of Oral and Maxillofacial Implantology, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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    • These authors contributed equally to this work.
  • Chenping Zhang,

    1. Department of Oral and Maxillofacial Surgery, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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  • Jian Sun,

    1. Department of Oral and Maxillofacial Surgery, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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  • Darnell Kaigler,

    1. Department of Periodontics and Oral Medicine and Biomedical Engineering, University of Michigan, Michigan Center of Oral Health Research, Ann Arbor, MI, USA
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  • Yiqun Wu

    Corresponding author
    1. Department of Oral and Maxillofacial Implantology, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
    • Corresponding author:

      Prof. Yiqun Wu

      Ninth People's Hospital Affiliated with Shanghai Jiao Tong University

      School of Medicine

      Shanghai 200011

      China

      Tel.: 86 21 53571699 ext5299

      Fax: 86 21 53073068

      e-mail: yiqunwu@hotmail.com

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Abstract

Purpose

The purpose of this study was twofold: (i) to compare vertical bone height (VBH) after tumor resection through grafting with either a double-barrel fibula (DBF) technique or vertical distraction osteogenesis of the fibula (VDOF); (ii) to compare the performance of loaded dental implants following either DBF or VDOF with special focus on implant survival, implant success, and bone resorption.

Materials and methods

This retrospective clinical study involved 19 patients who underwent implant placement following DBF (group A, n = 9) or VDOF (group B, n = 10) for mandibular reconstruction from March 2006 to May 2008. Clinical and radiographic assessments, including VBH, modified Plaque Index (mPI), modified Sulcus Bleeding Index (mSBI), and marginal bone level (MBL), were taken for both groups after delivery of the final prostheses and annually thereafter.

Results

Nine patients underwent DBF with 24 implants placed and 10 patients underwent VDOF with 27 implants placed for mandibular reconstruction after tumor resection. Overall, all DBF and VDOF procedures were successful for group A and group B. VBH for group A and group B were 20 and 17 mm. There was no statistically significant difference of mSBI scores between group A and group B in the 3-year follow-up (= 0.40). In four cases with eight implants of group A and two cases with three implants of group B, granulomatous soft tissue grew. There was no statistically significant differences of MBL between group A and group B in the 3-year follow-up (= 0.736). The cumulative survival and success rates of implants for group A were 100% and 87.5%, and for group B were 100% and 85.2% in 3-year follow-up, respectively.

Conclusions

On the basis of the study of 19 patients who received a total of 51 implants, reconstruction of the mandible with DBF flap or VDOF flap, combined with dental implant therapy, was considered a predictable option. Compared with implants placed in VDOF bone, implants placed in DBF bone had a relative higher incidence of associated gingival inflammation. The DBF bone seems more resistant to peri-implant resorption processes than VDOF bone during functional loading.

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