This multi-center retrospective study evaluated the survival and success of extra-short and short locking-taper dental implants placed in both maxillary and mandibular fibula grafts. A total of 37 patients were treated across five study sites and received 146 implants in fibula grafted sites. Out of those patients, 23 received prostheses, and they received 25 prostheses in total. Kaplan-Meier survival analysis was used to assess the survival and success rates of both implants and prostheses. Multivariate Cox regression and manifold learning were used to correlate study covariates to implant survival outcomes. Marginal bone levels surrounding implants supporting full arch prostheses were measured and correlated with the lengths of distal extensions. The overall thirteen-year implant survival rate was 86.9 % (95 % confidence interval: 75.5-93.2 %), while the implant success rate was 80.2 % (95 % confidence interval: 66.8-88.7 %.) The prosthesis survival rate at 13 years after prosthesis insertion was 90.0 % (95 % confidence interval: 65.6-97.4 %); while the prosthetic success rate was 78.9 % (95 % confidence interval: 56.2-90.7 %.) Hypertension, implant placement in the mandible, tooth loss from tumor, patient age, and lateral augmentation were correlated with reduced implant survival; while maxillary implant placement, osteoporosis and antiresorptive drug use, chemotherapy before implant surgery, and tooth loss from trauma were correlated with improved survival. Marginal bone levels around implant immediately adjacent to distal extensions were positively correlated with the lengths of distal extensions (R² = 0.74). Extra short and short locking-taper dental implants presented high survival and success rates when used to restore the dentition of patients receiving fibula grafts for maxillary or mandibular reconstruction.

There is limited information regarding implant and prosthetic survival after osseous microvascular free flap (OMFF). This case series aims to describe the placement of short and extra short implants in osseous microvascular free flaps to support prostheses, and present an up to 40-month retrospective follow-up. Short and extra short dental implants were placed in six fibula free flaps (FFF) and in two microvascular deep circumflex iliac artery (DCIA) flaps. In total, 27 short and extra short dental implants have been placed into two different types of free flaps. Kaplan–Meyer (K-M) survival analyses were performed to evaluate the survival and success outcomes of implants and prostheses. Out of the eight patients reconstructed with free flap, five were rehabilitated with prostheses, one patient has a temporary prosthesis, and two patients are in the process of prosthetic rehabilitation. Twenty-seven implants were followed up for up to 40 months, and K-M analyses showed 100% implant survival probability (95% confidence interval: 100%), while the implant success probability was 91.0% (95% confidence interval: 68.6–97.7%). Short and extra short dental implants placed in OMFF presented high survival and success rates in a retrospective case series after up to 40 months.

Placing dental implants in the microvascular bone free flaps used for reconstruction of mandible or maxilla is a technique that has been previously reported. However, there is a scarcity of data on the use of short dental implants in this situation, as well as on the performance of prosthetic restorations. Therefore, this prospective study enrolled 13 patients who have undergone jaw reconstruction using one of the four types of microvascular osseous flaps, who received a total of 44 implants. Patients who completed prosthetic rehabilitation answered questionnaires on their quality-of-life over the course of their treatment. The results revealed a high implant survival rate of 97.1% (95% CI: 80.9–99.6%), and a similarly high success rate of 88.2% (95% CI: 71.6–95.4%) at 63 months after implant surgery. Additionally, survey results revealed quality-of-life improvements after prosthetic rehabilitation, specifically in the areas of food and fluid intake, as well as articulating language. Overall, short implants in microvascular free flaps provide a robust solution for the functional rehabilitation of dentition in patients with head and neck malignancies.