Survival, Function, and Complications of Oral Implants Placed in Bone Flaps in Jaw Rehabilitation: A Systematic Review

Purpose: This systematic review attempted to determine the survival rate of implants placed in bone flaps in jaw rehabilitation and the functional gains and the most common complications related to these implants. Materials and Methods: An electronic search was undertaken of PubMed, EMBASE, and CNKI records from 1990 through July 2014. Two independent examiners read the titles and abstracts of the results to identify studies that met the inclusion criteria. Subsequently, the reference lists of the selected publications were hand searched. Descriptive statistics were used to report all data related to the survival rate of implants placed in bone flaps in jaw rehabilitation, the functional gains, and complications. Results: A total of 20 studies were included for systematic review without repetition. The mean follow-up time after implant placement ranged from 1.75 to 9.5 years. Within the limitations of available studies, the survival rate of implants placed in bone flaps in jaw rehabilitation ranged from 82.4% to 100%. Of the 20 included studies, 15 reported a survival rate higher than 90%. The cumulative survival rate was 93.2%, with the longest follow-up time being 12.9 years. The most common complications related to these implants were peri-implant bone resorption or peri-implant inflammation, and peri-implant soft tissue proliferation. The main factors associated with the survival rate of implants in bone flaps were reported as time of implant placement and radiotherapy. Despite some persistent soft tissue problems and implant loss, most patients reached a satisfactory functional and esthetic outcome, as evaluated by clinical examination and subjectively by the patients at interview. Implantsupported dental prosthetic rehabilitation in reconstructed jaws improved the quality of life in terms of speech, nutrition, oral competence, and facial appearance. Conclusion: Placement of implants in bone flaps in jaw rehabilitation was demonstrated to be a reliable technique with a high survival rate. Multicentered randomized controlled clinical trials and longer clinical studies should be undertaken in this area.