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VOLUME 8 , ISSUE 3 ( May-June, 2017 ) > List of Articles


Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps

Ashish R Jain

Citation Information : Jain AR. Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps. World J Dent 2017; 8 (3):171-176.

DOI: 10.5005/jp-journals-10015-1433

Published Online: 01-06-2017

Copyright Statement:  Copyright © 2017; The Author(s).



Functional reconstruction of jaw defects due to surgical resection is a challenge in maxillofacial surgery. The fibula free flap in combination with dental implants has exhibited growing popularity for such reconstructions. This study aimed at evaluating the clinical and functional outcome of dental implants inserted in fibula free flaps and dental implants used for orofacial reconstruction following ablation of tumors.

Materials and methods

A clinical follow-up study of 10 patients was conducted after oral surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 12-year period. The follow-up protocol included a clinical examination and radiological evaluation and interview using a questionnaire. Information on postoperative recovery after the surgical reconstruction phase and implant placement, type of diet, swallowing problems, speech intelligibility, lip competence, and perceived facial appearance was collected and analyzed.


The survival rate of fibula free flap was 100%. The survival and success rates of implants placed in the fibula flaps at the end of the follow-up period were 100 and 94% respectively.


Implants placed in fibula bone grafts have been shown to integrate normally. Surgical reconstruction with vascularized fibula bone grafts followed by placement of dental implants after jaw resection can provide good clinical and functional outcomes for oral rehabilitation with a prosthesis.

How to cite this article

A riga P, N arayanan V, J ain A R, Philip JM, Nathan S. Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps. World J Dent 2017;8(3):171-176.

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  1. Reconstruction of the mandible with free composite iliac bone grafts. Ann Plast Surg 1982 Nov;9(5):361-376.
  2. Experience with the osteocutaneous fibula flap: an analysis of 24 consecutive reconstructions of composite mandibular defects. J Craniomaxillofac Surg 1996 Dec;24(6):330-338.
  3. Use of the fibula free flap in maxillary reconstruction: a report of 3 cases. J Oral Maxillofac Surg 2002 May;60(5):567-574.
  4. The “double barrel” free vascularized fibular bone graft. Plast Reconstr Surg 1988 Mar;81(3):378-385.
  5. Restoration of masticatory function by microsurgically revascularized iliac crest bone grafts using enosseous implants. Plast Reconstruct Surg 1988 Jun;81(6):861-877.
  6. Orofacial and mandibular reconstruction with the iliac crest free flap: a review of 60 cases and a new method of classification. Plast Reconstr Surg 1989 Sep;84(3):391-403.
  7. The functional result of mandibular reconstruction. Laryngoscope 1990 Apr;100(4):364-374.
  8. Oromandibular reconstruction using microvascular composite free flaps. Report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects. Arch Otolaryngol Head Neck Surg 1991 Jul;117(7):733-744.
  9. Oromandibular reconstruction with the fibular free flap. Analysis of 50 consecutive flaps. Arch Otolaryngol Head Neck Surg 1997 Sep;123(9):939-944.
  10. Functional results of dental restoration with osseointegrated implants after mandible reconstruction. Plast Reconstruct Surg 1998 Mar;101(3):650-655.
  11. Vascularized bone flaps in oromandibular reconstruction. A comparative anatomic study of bone stock from various donor sites to assess suitability for enosseous dental implants. Arch Otolaryngol Head Neck Surg 1994 Jan;120(1):36-43.
  12. Functional mandibular reconstruction of patients with oral cancer. Oral Surg Oral Med Oral Pathol 1989 Oct;68(4 Pt 2):499-503.
  13. Postoperative function after implant insertion in vascularized bone grafts in maxilla and mandible. Plast Reconstr Surg 1996 Apr;97(4):719-725.
  14. A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofac Surg 1997 Nov;55(11):1200-1206.
  15. Mandibular reconstruction using vascularized fibula. Br J Plast Surg 1990 Jul;43(4):403-409.
  16. Evaluation of osseointegration of endosseous implants in radiated, vascularized fibula flaps to the mandible: a pilot study. J Oral Maxillofac Surg 1995 Jun;53(6):640-644.
  17. Oral rehabilitation with endosteal implants and free flaps. Int J Oral Maxillofac Surg 1996 Feb;25(1):3-12.
  18. Implants for patients with maxillofacial defects and following irradiation. In: Lang, NL.; Karring, T.; Lindhe, J., editors. Proceedings III European Workshop on Periodontology. Berlin: Quintessence;. Berlin: Quintessence; 1999. p. 557-607.
  19. Behavior of implants in bone grafts or free flaps after tumor resection. Clin Oral Implants Res 2000 Feb;11(1):66-75.
  20. Oral rehabilitation after mandibular reconstruction using an osteocutaneous fibula free flap with endosseous implants. Factors affecting the functional outcome in patients with oral cancer. Clin Oral Implants Res 2005 Feb;16(1):69-79.
  21. Masticatory function of postoperative tumor patients rehabilitated with osseointegrated implants. Int J Oral Maxillofac Surg 1996 Apr;54(4):441-447.
  22. Patients with reconstruction of craniofacial or intraoral defects: development of instruments to measure quality of life. Int J Oral Maxillofac Implants 2001 Mar-Apr;16(2):225-245.
  23. Oral rehabilitation with implant-retained prostheses following ablative surgery and reconstruction with free flaps. Int J Oral Maxillofac Implants 1997 Nov-Dec;12(6):820-827.
  24. Reconstructed mandibular defects: fibula free flaps and osseointegrated implants. Plast Reconstr Surg 1997 Feb;99(2):356-365.
  25. New possibilities for reconstructing extensive jaw defects with prefabricated microvascular fibula transplants and ITI implants. Mund Kiefer Gesichtschir 2000 Nov;4(6):365-372.
  26. Reconstruction of maxillary and mandibular defects using prefabricated microvascular fibular grafts and osseointegrated dental implants – a prospective study. Clin Oral Implants Res 2004 Oct;15(5):598-606.
  27. Clinical outcome of dental implants placed in fibula-free flaps used for the reconstruction of maxillo-mandibular defects following ablation for tumors or osteoradionecrosis. Clin Oral Implants Res 2006 Apr;17(2):220-228.
  28. Primary insertion of osseointegrated dental implants into fibula osteoseptocutaneous free flap for mandible reconstruction. Plast Reconstr Surg 1998 Sep;102(3):680-688.
  29. Use of the “double barrel” free vascularized fibula in mandibular reconstruction. J Oral Maxillofac Surg 1998 Jan;56(1):38-44.
  30. Oromandibular reconstruction with simultaneous free flaps: experience on 10 cases. Acta Otorhinolaryngol Ital 2003 Aug;23(4):281-290.
  31. Immediate loading of dental implants placed in revascularized fibula free flaps: a clinical report on 2 consecutive patients. Int J Oral Maxillofac Implants 2004 Nov-Dec;19(6):906-912.
  32. Dental implants in reconstructed jaws: patients’ evaluation of functional and quality-of-life outcomes. Int J Oral Maxillofac Implants 2003 Jan-Feb;18(1):127-134.
  33. Radiotherapy, osseointegration and hyperbaric oxygen therapy. Periodontol 2000 2003;33:145-162.
  34. A detailed analysis of titanium implants lost in irradiated tissues. Int J Oral Maxillofac Implants 1994;9:653-662.
  35. Bone-anchored reconstruction of the irradiated head and neck cancer patient. Otolaryngol Head Neck Surg 1993 Apr;108(4):334-343.
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