Long-term performance of dental implants in vascularized iliac crest grafts for mandibular reconstruction in 14 consecutive patients

Abstract

PURPOSE: To evaluate the long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction by clinical and radiographic examinations. METHODS: From 1995 to 2005, 47 implants installed in vascularized iliac crest grafts for mandibular reconstruction in 14 patients were analyzed, including 30 implants immediately placed into vascularized iliac crest grafts in 10 patients and 17 implants placed later in 4 patients. The cumulative survival rate within 15 years of dental implants and prostheses was evaluated. Clinical assessments and radiographic examination were performed 5 years and 10 years after implant loading. Statistical analysis was performed using SPSS 26.0 software package. RESULTS: No early failures occurred during the healing period. Cumulative survival rates of implants for 10 years and 15 years were 90.44% and 86.67% and cumulative survival rate of prostheses for 15 years was 78.32%, respectively. The average marginal bone loss at 5 years was (2.08 ±0.27) mm, while that at 10 years was (4.22±0.48) mm (P<0.0001). Biological complications were peri-implantitis and soft tissue hyperplasia, and mechanical complication was abrasion of the prostheses mainly. CONCLUSIONS: The long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction is stable, which is an effective method for mandibular defect reconstruction, but the incidence of peri-implantitis is relatively higher. So, maintaining the stability of soft and hard tissues around the implant is a crucial guarantee for the long-term performance of implants.