Lin Chin-Yu, Lin Chih-Hung, Chang Chung-Ta, Liao Yu-Fang, Muo Chih-Hsin, Huang Yi-Fang
Master's student, Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; and Resident, Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Professor, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; Professor, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Linkou, Taiwan; and Professor, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
J Prosthet Dent. 2025 Jul 11. doi: 10.1016/j.prosdent.2025.06.017.
Peri-implant bone resorption is a critical factor in evaluating the long-term success of dental implants. However, information regarding the difference in peri-implant bone resorption when implants are placed in microvascular fibula free (MFF) flaps is limited, and how jaw location may influence long-term peri-implant bone stability under functional occlusal loading over extended follow-up periods is unclear.
The purpose of this retrospective clinical study was to investigate the variables related to peri-implant fibular bone resorption under functional occlusal force between the jaws for at least a 12-year follow-up.
During the 12-year functional occlusion loading period, a total of 1444 successful endosseous dental implants were analyzed, including 880 implants placed in the mandibular MFF flap and 564 implants placed in the maxillary MFF flap in 212 patients with oral cancer. The clinical crown-to-implant ratio (C/I) was estimated from the panoramic images for each participant from 2011 to 2023. The C/I rate distribution per follow-up year was shown as mean ±SD for both groups. A generalized estimating equation (GEE) assessed the association between an implant site with an MFF flap reconstruction and risk factors (year, age, sex) on peri-implant bone changes, with C/I change indicating the impact. Statistical analyses, including the Student t test, were performed using a statistical software program (SAS version 9.4).
A significant difference was found between the maxillary and mandibular C/I change (95% CI=0.086 to 0.7867; P=.014). Additionally, the time was closely related to the change in peri-implant bone level (95% CI=0.001 to 0.006; P=.003). Patient age also significantly affected the annual change in the peri-implant bone height; as the age increased by 0.016 years, the annual C/I change reduced by 0.005 (95% CI=-0.028 to -0.005; P=.007).
Peri-implant bone resorption was found to be associated with the age, the duration of occlusal loading, and the location of the implant, either the MFF flap reconstructed maxilla or mandible. Implants placed in the MFF flap used to reconstruct the mandible had higher stability than those implants installed in the maxillary MFF flap under long-term occlusal loading.
种植体周围骨吸收是评估牙种植体长期成功的关键因素。然而，关于将种植体植入游离腓骨微血管（MFF）瓣时种植体周围骨吸收差异的信息有限，并且在长期随访期间，颌骨位置如何在功能性咬合负荷下影响种植体周围骨的长期稳定性尚不清楚。
本回顾性临床研究的目的是调查在至少12年的随访期内，颌骨间功能性咬合力作用下与种植体周围腓骨骨吸收相关的变量。
在12年的功能性咬合负荷期内，共分析了1444颗成功的骨内牙种植体，其中包括212例口腔癌患者中880颗植入下颌MFF瓣的种植体和564颗植入上颌MFF瓣的种植体。从2011年至2023年为每位参与者的全景图像估算临床冠根比（C/I）。两组每年随访的C/I率分布以平均值±标准差表示。广义估计方程（GEE）评估了采用MFF瓣重建的种植部位与种植体周围骨变化的风险因素（年份、年龄、性别）之间的关联，C/I变化表明其影响。使用统计软件程序（SAS 9.4版）进行包括Student t检验在内的统计分析。
上颌和下颌C/I变化之间存在显著差异（95%CI = 0.086至0.7867；P = 0.014）。此外，时间与种植体周围骨水平变化密切相关（95%CI = 0.001至0.006；P = 0.003）。患者年龄也显著影响种植体周围骨高度的年度变化；年龄每增加0.016岁，年度C/I变化降低0.005（95%CI = -0.028至-0.005；P = 0.007）。
发现种植体周围骨吸收与年龄、咬合负荷持续时间以及种植体位置（MFF瓣重建的上颌或下颌）有关。在长期咬合负荷下，植入用于重建下颌的MFF瓣中的种植体比植入上颌MFF瓣中的种植体具有更高的稳定性。
