The fate of osseointegrated implants in patients following oral cancer surgery and mandibular reconstruction.

BACKGROUND The feasibility of implant treatment in patients after oral ablative tumor surgery and defect reconstruction has not yet been investigated in terms of the requisite high standards of success assessment. A report on this topic must address not only implant survival but implant health, bone response, soft tissue health, failure pattern, and time of failure, as well. METHODS From June 1990 through December 1997, 90 patients received 320 dental implants after oral tumor resection and immediate soft tissue reconstruction. Included in the study were 45 patients with 162 implants loaded for at least 1 year. Regular follow-up for 6 years consisted of detailed medical history and evaluation of periodontal parameters. Out of this population, 10 vascularized iliac bone grafts for mandibular reconstruction containing loaded implants were selectively evaluated for bone loss. RESULTS The assessment of pocket probing depths, plaque accumulation, bleeding disposition, implant mobility by means of the Periotest method applied to the restoration type, horizontal and vertical (peri-implant) bone loss according to x-ray findings, causes and time of implant loss, and subjective statements offered results comparable to those found in healthy subjects examined with periodontal success parameters. CONCLUSION Prosthetic restoration of patients after oral ablative tumor surgery followed by hard and soft tissue reconstruction can be achieved with dental implants with similar long-term efficacy as found in healthy subjects adhering to internationally established requirements.