Immediate loading of dental implants placed in revascularized fibula free flaps: a clinical report on 2 consecutive patients

PURPOSE: The objective of this study was to report the clinical outcome of dental implants placed in revascularized fibula flaps for the reconstruction of severely atrophied edentulous maxillae and immediately loaded with full-arch implant-supported prostheses. MATERIALS AND METHODS: Two patients, a 55-year-old woman and a 59-year-old woman, who presented with severely atrophied edentulous maxillae and local anatomy incompatible with rehabilitation with conventional complete removable dentures and insufficient bone volume for placement of implants of adequate dimensions were selected for reconstruction with revascularized fibula free flaps. Three months after the reconstructive procedure, Br?nemark System dental implants (8 in the 55-year-old patient, 7 in the 59-year-old patient) were placed in the reconstructed areas and immediately loaded with implant-supported full-arch prostheses. The mean follow-up period of implants after the start of prosthetic loading was 24 months. Radiographic peri-implant bone level changes and peri-implant clinical parameters (Plaque Index, Bleeding Index, and probing depth) were evaluated. RESULTS: No implants were lost during the follow-up period. Implant survival and success rates were 100% and 93.3%, respectively. Peri-implant clinical parameters presented values consistent with those obtained for implants placed in native nonreconstructed bone and allowed to heal before loading. DISCUSSION: To the authors' knowledge, this is the first time that the successful immediate loading of implants placed in fibula free flaps for the rehabilitation of totally edentulous patients with severely resorbed maxillae or mandibles has been described. CONCLUSION: Despite the limited number of patients and the short follow-up period, immediate loading of implants placed in revascularized fibula free flaps appears to be a reliable method for the dental rehabilitation of these patients.