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.

BACKGROUND: 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. METHODS: 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. RESULTS: There was a statistically significant increase in stability after 3 and 6 months, and there was a decrease in density after 6 months. The patient satisfaction improved over the follow-up period. CONCLUSION: 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.