Assessing Dental Implant Success: A Systematic Review and Meta-Analysis of Primary Versus Secondary Implantation in Free Bone Flap Reconstruction for Malignant Tumors.

BACKGROUND: Dental implantation of bone reconstructions in oncologic situations improves patients' orofacial function and quality of life. There are currently no recommendations on the timing of implantation. METHODS: This systematic review with meta-analysis aimed to compare primary and secondary dental implantation of free bone flaps in reconstructions for malignant tumors of the oral cavity. The primary objective was to evaluate the implant survival rate, with secondary criteria including time to prosthesis placement, postoperative complications, and data on quality of life. Results-Three databases were screened for articles published between January 1990 and April 2024. Out of 2438 studies, 16 met the eligibility criteria, encompassing 284 patients. In total, 319 implants were placed in the primary implantation group and 1108 in the second group. Implant survival rate was 92.5% in the primary implantation group compared to 88.5% in the secondary implantation group. This systematic review underscores a higher success rate for implants placed primarily in patients with oral cancer. CONCLUSIONS: Given the rapid functional and aesthetic improvement offered by prosthetic rehabilitation, primary implantation should be systematically considered in the oncological population.