The Effect of Different Transplanted Soft Tissues on Bone Resorption Around Loaded Endosseous Implants in Patients After Oral Tumor Surgery
Adorján Kovács, MD, DMD.
One hundred eighty-five dental implants loaded for at least 1 year in 49 patients treated with ablative tumor and reconstructive surgery in the oral cavity were examined to ascertain peri-implant bone resorption. While 96 implants penetrated local mucosa and served as the control group, 27 implants were associated with split-thickness skin grafts, 9 in mucosal grafts, 18 in myocutaneous flaps, 30 in jejunal grafts, and 5 in a vastus lateralis and a temporalis muscle flap. Restoration type was similar in all groups (overdentures) except for implants placed in the jejunal grafts (fixed implant-supported prostheses). Regular follow-up was done over an observation period of 3 to 5 years after implant placement. Overall survival rate of the 89 implants surrounded by transplanted soft tissues was 94.1%. Bone loss under the various transplanted soft tissues was similar to or less than that under local mucosa. Over time, only horizontal bone resorption under jejunal grafts and vertical bone resorption under mucosal grafts showed higher values. Mean values of all measurements for split-thickness skin grafts were higher than for local mucosa for the horizontal as well as for the vertical resorption pattern. It can be concluded that transplanted tissues foreign to the oral cavity have no detrimental effect on bone resorption around loaded dental implants and do not endanger their long-term stability. Of all the transplants used, split-thickness skin grafts are least recommended as peri-implant soft tissue. (INT J ORAL MAXILLOFAC IMPLANTS 1998;13:554–560) Key words: dental implants, jejunal graft, long-term results, myocutaneous flaps, peri-implant bone loss, soft tissue