Dental implants in reconstructed jaws: implant longevity and peri-implant tissue outcomes.

PURPOSE: The study aimed to evaluate the clinical status and survival of dental implants inserted in reconstructed jaws, with particular reference to the peri-implant tissues. MATERIALS AND METHODS: We conducted a clinical follow-up study based on 29 rehabilitated patients after oral tumor surgery, who received autogenous bone grafts from the ilium and endosseous implants (14 maxillary and 15 mandibular cases; 140 implants) for functional jaw reconstruction between 1988 and 1999. Clinical records of the patients were reviewed retrospectively. Clinical parameters of plaque index, probing pocket depth, and bleeding on probing were assessed around the implants and control teeth at 4 locations (mesiobuccal, distobuccal, mesiolingual, and distolingual). Implant mobility was assessed clinically and objectively using a Periotest (Gulden; Siemens, Bensheim, Germany) equipment for those implants supporting removable prostheses. Radiographically, the proportion of implant length remained osseointegrated was measured. RESULTS: With a mean follow-up time of 50 months, 90.7% of the 140 implants placed were functional in supporting dental prostheses; 4.3% of implants failed in osseointegration and the remaining 5.0% implants were osseointegrated but nonfunctional. A total of 493 sites of 127 functional implants and 392 sites of 98 control teeth were assessed. No significant difference was found between the implants and control teeth parameters, except on the probing pocket depth. The mean peri-implant probing depth was 3.5 mm, and 52.7% of the measured sites were 3 mm or less. More than one third of the implants (35.9%) presented with increased probing depth (> or =4 mm), and this was significantly higher than in the control teeth (P <.001, chi(2) test). Bleeding on probing was found in 19.3% of the measured peri-implant sites, corresponding to 42.2% of the dental implants. Of the implants, 28.9% were completely free from plaque and 9.4% show visible plaque accumulation. Mobility assessment was feasible on 32 implants and no mobility was detected. Radiographically, the mean implant length remained in bone was 81.1%, with 82.6% in the maxilla and 79.4% in the mandible. Implant survival rate calculated using the Kaplan-Meier method was 86.9% for 5 years. Based on the defined criteria, the success rate of implants placed in reconstructed jaws in this study was 90.7%. CONCLUSION: Endosseous implants can be successfully placed in reconstructed jaws for oral rehabilitation with maintenance of reasonable health status of the peri-implant tissues in the long-term.

Dental implants in reconstructed jaws: patients' evaluation of functional and quality-of-life outcomes.

PURPOSE: To evaluate the quality-of-life aspect of treatment outcome following functional jaw reconstruction and dental implants in the maxilla or mandible. MATERIALS AND METHODS: This cross-sectional study used a questionnaire interview of 28 rehabilitated patients who received autogenous bone grafts from the ilium and endosseous implants (14 maxillary and 14 mandibular cases; 134 implants) for functional jaw reconstruction between 1988 and 1999. A questionnaire was developed to assess the quality-of-life outcome for those patients who had finished their rehabilitation at least 6 months prior to the interview. Responses to the questions were recorded by means of visual analog scales. RESULTS: In general, patients gave positive comments on the restoration of their orofacial appearance and function (mastication and speech). The majority (85.7%) found no problem in various daily social activities, including dining in public. DISCUSSION: The overall level of satisfaction with the treatment outcome and the degree of recommendation of the treatment to others were both favorable (mean scores 8.6 and 8.7 out of 10, respectively). CONCLUSION: Oral rehabilitation using functional jaw reconstruction can reach a satisfactory level of esthetics, function, and psychosocial well being of patients, thus improving their quality of life.