POSTOPERATIVE FUNCTION AFTER IMPLANT INSERTION IN VASCULARIZED BONE-GRAFTS IN MAXILLA AND MANDIBLE

Between 1988 and 1992, 80 Branemark-type implants were inserted in 18 patients during reconstruction of the mandible or maxilla with vascula rized iliac crest or scapula crafts with or without additional soft ti ssue pedicles. In these procedures, nine vascularized bone grafts were combined with a primary insertion of 32 implants and a secondary inse rtion of 48 implants. Twelve patients are currently wearing the implan t-borne dentures. From 32 implants inserted primarily, eight could not be used for prosthodontic rehabilitation because three were lost with a graft, three were left as sleepers, and two demonstrated a lack of osseointegration. None of the implants inserted secondarily in grafts were lost. Primary implant insertion should be performed only in dose cooperation with the prosthodontist and in selected cases, for example , in free-end reconstruction of the mandible with a straight graft and where a limited number of implants is needed. Although restoration of masticatory function in patients with head and neck cancer can be ach ieved, compared with a healthy control group, functional impairments r emain. Patients subjectively favor the nonreconstructed side of the ma ndible or maxilla for chewing. These findings can be correlated with a postoperative follow-up investigation using a miniature force transdu cer and the T-scan system.