Relationship between fibula free flap complications and dental implant outcomes: a retrospective cohort study
Research article published in Frontiers in oral health (2025)
Abstract
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.
Summary
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Why This Matters for Hirudotherapy
This retrospective single-center cohort of 29 patients tracked how complications of fibula free flap (FFF) jaw reconstruction affected later implant-supported oral rehabilitation, finding that recipient-site wound-healing defects occurred in 31% and were independently linked to multisegment osteotomies and longer operative time, while failed implants correlated with poorer speech intelligibility and aesthetics; nonetheless 96% spoke intelligibly and judged aesthetics good or excellent. For hirudotherapy the relevance is contextual rather than direct: free-flap and microvascular reconstruction is precisely the surgical setting in which medicinal leeches are used as salvage therapy for venous congestion, and this study underscores how flap vascular resilience drives long-term success. The abstract does not study or mention leech therapy, and with only 29 patients at a single center the findings are hypothesis-level and cannot be generalized.
Citation
Relationship between fibula free flap complications and dental implant outcomes: a retrospective cohort study.
Attia et al. · Frontiers in oral health, 2025
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