Multicenter 14-year follow-up of fibula vascular grafts of mandibles and maxillae restored with short and extra-short implants.

PURPOSE: 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. METHODS: 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. RESULTS: 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 (R(2) = 0.74). CONCLUSION: 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.