Survival and success rate of dental implants placed in autologous compressed particulate corticocancellous bone graft post-tumour ablative surgery in the mandible

Abstract

Background Oro-dental rehabilitation is one of the most important concerns after ablative surgery of maxillofacial pathology. Discussion around dental implant use in vascularised bone graft (VBG) and nonvascularized bone graft (NVBG) has been evaluated thoroughly in the literature. Outcome of dental implants in NVBG has largely focussed on non-vascularised block graft, with paucity of studies that have evaluated success and survival of dental implants in particle bone and cancellous marrow (PBCM) type of bone graft. Aim The aim of this study was to evaluate the success and survival rate of the dental implants placed in autologous PBCM grafts. Materials and Methods All patients who had been reconstructed with nonvascularized PBCM graft after benign tumour ablative surgery and had dental implants inserted in the bone graft after healing were included in the study. Minimum requirement was 1 year of implants loaded with dental prosthesis continuously. Albrektsson’s success criteria and International Congress of Oral Implantologists recommendation were used to evaluate the success and survival rate of the dental implants. Assessment of bone level, peri-implant tissue, implant mobility, and pain were done as part of implant evaluation criteria. Results A total of 16 patients were included in the study (10 females and 6 males, mean age of 31.3 years). The mean mandibular continuity defect reconstructed with reconstructed with PBCM graft was 11.3 cm. Sixty-seven (67) dental implants were implanted in the grafted bone. Of the 67 implants, 5 failed (four of them failed before loading with dental prosthesis). One of the remaining 63 implants dental implant failed after loading of prosthesis. Accumulative success and survival rate of dental implant in particulate bone graft are 80.6% and 98.6% respectively. Conclusion Reconstruction of mandibular continuity defects with PBCM graft offer a viable alternative to vascularized bone graft. With this technique mandibular shape, width, height, and continuity were restored. The implant success and survival rate in this study are comparable to those implanted in fibula or native bone. It is recommended that future studies be designed to compare and evaluate the performance of dental implants in vascularized and nonvascularized PBCM bone graft.