THE EFFECT OF DIFFERENT TRANSPLANTED SOFT-TISSUES ON BONE-RESORPTION AROUND LOADED ENDOSSEOUS IMPLANTS IN PATIENTS AFTER ORAL TUMOR SURGERY

One hundred eighty-five dental implants loaded for at least 1 year in 49 patients treated with ablative tumor and reconstructive surgery in the oral cavity were examined to ascertain peri-implant bone resorptio n. While 96 implants penetrated local mucosa and served as the control group, 27 implants were associated with split-thickness skin grafts, 9 in mucosal grafts, 18 in myocutaneous flaps, 30 in jejunal grafts, a nd 5 in a vastus lateralis and a temporalis muscle flap. Restoration t ype was similar in all groups (overdentures) except for implants place d in the jejunal grafts (fixed implant-supported prostheses). Regular follow-up was done over an observation period of 3 to 5 years after im plant placement. Overall survival rate of the 89 implants surrounded b y transplanted soft tissues was 94.1%. Bone loss under the various tra nsplanted soft tissues was similar to or less than that under local mu cosa. Over time, only horizontal bone resorption under jejunal grafts and vertical bone resorption under mucosal grafts showed higher values . Mean values of all measurements for split-thickness skin grafts were higher than for local mucosa for the horizontal as well as for the ve rtical resorption pattern. It carl be concluded that transplanted tiss ues foreign to the oral cavity have no detrimental effect on bone reso rption around loaded dental implants and do not endanger their long-te rm stability. Of all the transplants used, split-thickness skin grafts are least recommended as peri-implant soft tissue.