Dental News - Periimplant soft-tissue management in patients with a fibula free flap reconstruction: Case series and description of a new technique

Dr. Silvio Mario Meloni, Mario Tallarico, Luigi Canullo Giacomo De Riu & Olindo Massarelli

Wed. 11. January 2017

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The aim of the present pilot case series study was to present a new technique for managing the periimplant soft tissue before implant placement, the soft-tissue template technique.

Materials and methods
This study was designed as a pilot case series study. At least six months after reconstruction with a fibula free flap, all crestal soft tissue, including skin and muscle, was removed, leaving only periosteum attached to the reconstructed alveolar crest. The soft tissue was then remodeled according to a new technique. One month after complete soft-tissue healing, implants were inserted with a flapless technique using a computer-guided template. Three to six months later, a screw-retained prosthesis was delivered. Outcome measures were implant survival and periimplant mucosal response, based on probing pocket depth (PPD) and bleeding on probing (BOP).

Results
Six patients (four males and two females) with a mean age of 48.4 years were treated. A total of 32 implants were inserted. No dropout occurred during the entire follow-up period. No implant failed and the overall implant survival rate was 100% 12 months after definitive prosthesis delivery. All of the patients presented with healthy soft tissue, stable PPD and good BOP values at the one-year follow-up. The mean PPD values were 3.6 ± 0.6 mm and the mean BOP values were 9 ± 4.8%.

Conclusion
Within the limitations of the study, this technique appeared to improve the quality of transplanted periimplant soft tissue. Further clinical trials are needed to validate this approach.

Editorial note: The full article was published in the 4/2016 issue of the Journal of Oral Science and Rehabilitation. It can be access free of charge at www.dtscience.com.

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