School of Medicine, University of Queensland, Herston, Queensland, Australia.
Metro North Oral Health Centre, Metro North Hospital and Health Service, Herston, Queensland, Australia.
Clin Oral Implants Res. 2021 Oct;32(10):1251-1261. doi: 10.1111/clr.13822. Epub 2021 Aug 11.
To evaluate implant survival, success and prosthodontic outcomes in a variety of composite free flaps.
A retrospective analysis of patient records was used for data collection of implants placed into flaps. Free flap donor sites included fibula, iliac crest, scapula, medial femoral condyle and radial forearm. Kaplan-Meier survival curves were used to estimate survival. Cox regression was used to assess variables affecting survival, and binary logistic regression was utilised to determine effect of variables on prosthodontic outcomes.
There were 150 implants placed into 45 fibula, 98 implants into 29 iliac crest, 62 implants into 22 scapula, 6 implants into 3 medial femoral condyle and 2 implants in radial forearm composite free flaps. There was no difference in survival or success between or within the various flaps. Active smoking, increasing age, male gender and radiotherapy were associated with implant failure. Of patients completing prosthodontic rehabilitation, 93% were successful. There was no difference in likelihood of failure between different flap types. Fixed implant-supported dentures were associated with poor oral hygiene compared with removable designs (OR2.9, 95%CI 1.1-7.8, p = .03).
There is adequate survival and success of implants in common flaps. Caution is required when planning implants in patients exposed to radiotherapy and smokers. Ability to maintain adequate oral hygiene is an important prosthetic design consideration.
评估各种复合游离皮瓣中种植体的存活率、成功率和修复效果。
通过回顾性分析患者的病历，收集种植体植入皮瓣的数据。游离皮瓣供区包括腓骨、髂嵴、肩胛骨、股骨内侧髁和桡骨。采用 Kaplan-Meier 生存曲线估计存活率。Cox 回归分析评估影响存活率的变量，二项逻辑回归用于确定变量对修复效果的影响。
共 150 枚种植体植入 45 例腓骨复合游离皮瓣，98 枚种植体植入 29 例髂嵴复合游离皮瓣，62 枚种植体植入 22 例肩胛骨复合游离皮瓣，6 枚种植体植入 3 例股骨内侧髁复合游离皮瓣，2 枚种植体植入桡骨复合游离皮瓣。不同皮瓣之间或同一皮瓣内的种植体存活率和成功率无差异。吸烟、年龄增长、男性和放疗与种植体失败有关。完成修复治疗的患者中，93%是成功的。不同皮瓣类型之间失败的可能性无差异。与可摘义齿设计相比，固定种植体支持的义齿与较差的口腔卫生有关（OR2.9，95%CI 1.1-7.8，p=0.03）。
在常见皮瓣中，种植体的存活率和成功率较高。对于接受放疗和吸烟者，在计划植入种植体时应谨慎。保持良好的口腔卫生能力是修复设计的重要考虑因素。
