Relationship between fibula free flap complications and dental implant outcomes: a retrospective cohort study

OBJECTIVE: To clarify how fibula free flap (FFF) complications influence clinical and functional outcomes after implant-supported oral rehabilitation. MATERIALS AND METHODS: A single-center retrospective cohort of 29 patients (56.41 ± 12.74 years; 31% female, 69% male) who underwent segmental jaw resection, FFF reconstruction and subsequent implant placement (2002-2010) was analyzed. Demographic, oncologic, flap, implant-related and patient-centered functional variables were extracted; associations were tested with exact, rank and regression statistics (⍺ = 0.05). RESULT: Patients received 7.14 ± 3.06 implants each and 72% were restored with telescopic overdentures. Recipient-site wound-healing defects (WHD) occurred in 31% and were independently associated with multisegment osteotomies (p = 0.012) and longer operative time (p = 0.026); partial flap loss (PFL) was infrequent (6.9%). WHD reduced maximum inter-incisal opening (MIO) by 0.8 cm and PFL by 2.8 cm, both impairing contour ratings. Implant failure (0.59 ± 1.59) correlated with poorer speech intelligibility (p = 0.004) and lower aesthetic scores (p = 0.032). Nonetheless, 96% of patients spoke intelligibly (with or without concentration), 96% judged their dental aesthetic as good or excellent, and 75% consumed a normal diet. Ordinal regression confirmed the number of fibula segments as the sole predictor of contour (p = 0.001). CONCLUSIONS: FFF reconstruction permits dependable, implant-supported rehabilitation, but multisegment osteotomies and prolonged surgery heighten soft-tissue morbidity, which in turn constrains both MIO and appearance. Failed implants further degrade speech intelligibility and aesthetics. Long-term success therefore hinges on balancing the contour gains of complex osteotomies with flap vascular resilience while safeguarding implant stability.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist

More peer-reviewed studies in Klinische Studien.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →