alexa Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation.
Surgery

Surgery

Reconstructive Surgery & Anaplastology

Author(s): Curi MM, Oliveira MF, Molina G, Cardoso CL, Oliveira Lde G,

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Abstract PURPOSE: Few reports have evaluated cumulative survival rates of extraoral rehabilitation and peri-implant soft tissue reaction at long-term follow-up. The objective of this study was to evaluate implant and prosthesis survival rates and the soft tissue reactions around the extraoral implants used to support craniofacial prostheses. MATERIALS AND METHODS: A retrospective study was performed of patients who received implants for craniofacial rehabilitation from 2003 to 2010. Two outcome variables were considered: implant and prosthetic success. The following predictor variables were recorded: gender, age, implant placement location, number and size of implants, irradiation status in the treated field, date of prosthesis delivery, soft tissue response, and date of last follow-up. A statistical model was used to estimate survival rates and associated confidence intervals. We randomly selected 1 implant per patient for analysis. Data were analyzed using the Kaplan-Meier method and log-rank test to compare survival curves. RESULTS: A total of 150 titanium implants were placed in 56 patients. The 2-year overall implant survival rates were 94.1\% for auricular implants, 90.9\% for nasal implants, 100\% for orbital implants, and 100\% for complex midfacial implants (P = .585). The implant survival rates were 100\% for implants placed in irradiated patients and 94.4\% for those placed in nonirradiated patients (P = .324). The 2-year overall prosthesis survival rates were 100\% for auricular implants, 90.0\% for nasal implants, 92.3\% for orbital implants, and 100\% for complex midfacial implants (P = .363). The evaluation of the peri-implant soft tissue response showed that 15 patients (26.7\%) had a grade 0 soft tissue reaction, 30 (53.5\%) had grade 1, 6 (10.7\%) had grade 2, and 5 (8.9\%) had grade 3. CONCLUSIONS: From this study, it was concluded that craniofacial rehabilitation with extraoral implants is a safe, reliable, and predictable method to restore the patient's normal appearance. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved. This article was published in J Oral Maxillofac Surg and referenced in Reconstructive Surgery & Anaplastology

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