Original Article
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World J Stomatol. Aug 20, 2013; 2(3): 48-55
Published online Aug 20, 2013. doi: 10.5321/wjs.v2.i3.48
Clinical evaluation of implants in patients with maxillofacial defects
Belir Atalay, Hakan Bilhan, Onur Geckili, Caglar Bilmenoglu, Ugur Meric
Belir Atalay, Ugur Meric, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey
Hakan Bilhan, Onur Geckili, Caglar Bilmenoglu, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey
Author contributions: Atalay B performed the surgeries; Bilhan H designed the study and wrote the manuscript; Geckili O made the prostheses of the patients; Bilmenoglu C and Meric U found the patients and planned the treatments.
Correspondence to: Dr. Onur Geckili, Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, 2nd floor, Istanbul 34093, Turkey. geckili@istanbul.edu.tr
Telephone: +90-212-4142020 Fax:+90-212-5352585
Received: February 16, 2013
Revised: March 27, 2013
Accepted: April 10, 2013
Published online: August 20, 2013
Processing time: 112 Days and 9.9 Hours
Abstract

AIM: To show the efficacy of reconstruction and rehabilitation of large acquired maxillofacial defects due to tumor resections and firearm injuries.

METHODS: The study group comprised of 16 patients (10 men and 6 women) who were operated on because of their maxillofacial defects under local and general anesthesia between June 2007 and June 2011. Prosthetic treatment with the aid of dental implants was performed for all of the patients. Eight patients received an implant supported fixed prosthesis; six patients received implant supported overdentures and two patients received both. Patients were followed up postoperatively for 1 to 4 years. Implant success and survival rates were recorded. Panoramic radiographs were taken preoperatively, immediately after surgery, immediately after loading and at every recall session. Peri-implant and prosthetic complications were recorded. Subjects were asked to grade their oral health satisfaction after treatment according to 100 mm visual analog scale (VAS) and the oral health related quality of life of the patients was measured with the short-form Oral Health Impact Profile.

RESULTS: Five implants (3 in the mandible, 2 in the maxilla) in five patients were lost, while the other 53 survived, which brings an overall survival rate of 91.37% on the implant basis, but 68.75% on patient basis. All the failed implants were lost before abutment connection and were therefore regarded as early failures. For all failed implants, new implants were placed after a 2 mo period and the planning was maintained. The mean marginal bone loss (MBL) was 1.4 mm on the mesial side and 1.6 mm on the distal side of the implants. Five of the implants showed MBL > 2 mm (mean MBL = 2.3 mm) but less than 1/2 of the implant bodies and therefore were regarded as not successful but surviving implants. The VAS General Comfort mean score was 85.07, the VAS Speech mean score was 75.25 and the VAS Esthetics mean score was 82.74. No patient reported low scores (score lower than 50) of satisfaction in any of the evaluated factors. The mean of OHIP-14 scores was 5.5.

CONCLUSION: Although further follow up and larger case numbers will give more information about the success of dental implants as a treatment modality in maxillofacial defects patients, the actual results are encouraging and can be recommended for similar cases.

Keywords: Dental implant; Maxillofacial defect; Overdenture; Prosthesis; Visual analog scale; Marginal bone loss

Core tip: Dental implant treatment is efficient in the reconstruction and rehabilitation of large acquired maxillofacial defects due to tumor resections and firearm injuries. Although further follow up and larger case numbers will give more information about the success of dental implants as a treatment modality in patients with maxillofacial defects, the actual results are encouraging and can be recommended for similar cases.