Assessment of bone density and stability with immediately loaded dental implants with the All-on-Four technique in free vascularized fibular grafts used for mandibular reconstruction.

Abstract

Following free fibula flaps (FFF) reconstruction of mandibular defects the patients need an early dental rehabilitation to regain their masticatory function and enhance their feeding and nutrition. This study included 10 patients, with mandibular defects previously reconstructed with FFF that span the area between the two mandibular angles. They received a full arch fixed restoration supported by four implants using a pilot drilling guide to perform a flapless operation. The stability of the placed dental implants was assessed along with the changes in bone density. There was a statistically significant increase in stability after 3 and 6months, and there was a decrease in density after 6months. The patient satisfaction improved over the follow-up period. The All-on-Four technique is reliable and economic for early functional rehabilitation of resected jaws reconstructed with FFF; however, further studies are needed to investigate the changes in fibula bone density over time and with function.