Evaluation of postoperative peri-implant reactive tissues following implant supported prosthetic rehabilitation in fibula free flaps

Objectives. The purpose of this study was to measure the frequency of peri-implant reactive tissue development in a cohort of patients following immediate implant supported prosthetic rehabilitation in fibula free flaps at our institution and to document 2 cases of management based on our institution's experience. Study Design. To address this question of study design, a case series was performed from October 2014 to May 2022. We included patients that underwent a fibula free flap reconstruction of the mandible or maxilla with immediate implant placement and dental prostheses fabrication. Forty-four patients met the inclusion criteria, and, among the participants, a total of 26 male patients (59%) and 18 female patients (41%) were evaluated, with 185 implants placed all together. Results. Twenty patients (45%) were treated for benign pathology, 12 with malignant pathology (27%), 5 with trauma (11%), and 7 with osteoradionecrosis (16%). Postoperative peri-implant reactive tissues were seen to develop at 39 of the implant sites (21%). Conclusion. Reactive tissues were found to be a common complication in patients treated with fibular free flap reconstructions involving implant rehabilitation. Our institution noted that local excision of such reactive tissues, in addition to silver nitrate cauterization and topical steroid application, may provide reasonable success in dealing with these occurrences. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range) (Oral Surg Oral Med Oral Pathol Oral Radiol 2024;138:e107-e112)