Retrospective Assessment of the Peri-implant Mucosa of Implants Inserted in Reanastomosed or Free Bone Grafts from the Fibula or Iliac Crest

Purpose: To investigate the susceptibility of implants to inflammation following autogenous bone transplantation and to evaluate whether various factors affect outcomes. Materials and Methods: This retrospective cross-sectional clinical investigation involved patients who were treated between the years 1994 and 1996. The donor site, mode of transplantation, primary disease, gender, smoking habits, and age were evaluated with respect to outcomes. Clinical and radiologic assessments were the basis for the classification into 3 categories: (1) no inflammation, (2) mucositis, and (3) peri-implantitis. Lost implants were also noted. The data were evaluated statistically to determine whether significant differences existed. Results: Forty-three patients (23 men and 20 women) were involved in this retrospective study. These patients received a total of 216 oral implants over a follow-up time of 8 to 10 years. Depending on the type of reconstruction, rates of peri-implant inflammation between 9% and 38% were observed. For mucositis, rates of 16.3% to 24.1% were seen, and 30% to 70.9% of sites showed no inflammation. Conclusion: High rates of soft tissue inflammation adjacent to implants were observed. The choice of donor site in conjunction with the mode of transplantation seemed to influence the development of peri-implant inflammation. The microsurgically reanastomosed fibula seemed most resistant to inflammatory processes, followed by the microsurgically reanastomosed iliac crest, free iliac crest, and free fibula. No significant differences could be observed for primary disease. These findings should be taken into consideration prior to surgery and when establishing individual recall systems. Keywords: free bone transplantation, jaw reconstruction, microsurgical transplantation, oral implants, peri-implantitis