Implant success in irradiated free fibula flaps for mandible reconstruction

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Alistair Varidel, Pasquale Mollica and Leinkram

Westmead Hospital, Australia

: J Otol Rhinol

Abstract

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Background: Free fibula reconstruction of segmental mandible defects is a commonly accepted method of rehabilitation following ablation for head and neck squamous cell carcinoma. Fibula reconstruction is made particularly useful by its ability to successfully osseointegrate dental implants, thus allowing for improved functional and aesthetic rehabilitation. However, in cases requiring post reconstruction radiotherapy, the intention to continue with implant placement should be re- evaluated. While it is commonly understood that irradiated tissues have much poorer healing qualities than non-irradiated tissues, very little evidence exists as to the specific success rates and risks of placing implants in these neo-mandibles. Methods: Three databases were searched for all papers related to implant placement in irradiated free fibula mandible reconstructions. Findings: Limited studies considered implants in irradiated fibula flaps. Retrospective studies appear to support that these implants have over 80 percent survival. At this stage, the specific associated complications are largely unreported. Conclusion: Current data on implant success in irradiated free fibula mandible reconstructions is limited. However, present literature suggests that these implants pose a reasonable success rate. This piece found that the survival of implants in these patients is certainly less than the accepted success of implants in non-irradiated free fibula reconstructions. However, the authors of this paper propose that continuing with implant placement in irradiated fibulas is a reasonable and somewhat reliable option for oral rehabilitation.

Biography

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Alistair Varidel completed his Bachelor of Dental Science (BDSc) at the University of Queensland in 2011 and his Bachelor of Medicine and Bachelor of Surgery (MBBS) at the University of Sydney in 2015. He then went on to commence his Master of Surgery through the University of Sydney. He is currently completing his Master’s Dissertation in the field of Craniofacial Surgery, looking at the effects of prophylactic tranexamic acid use in paediatric craniosynostosis surgery. He completed Internship and Residency at Westmead Hospital, Sydney and has recently been accepted into the Oral and Maxillofacial Surgery training program in South Australia.