Non-Cochrane · prognostic · PM41681753
Mid-Term Outcomes, Biological Responses and Complications of Dental Implants in Maxillomandibular Reconstruction with Free Bone Flaps: A Systematic Review and Meta-Analysis.
Qiu Siqi, Hung Kuo Feng, Wang Feng · Diagnostics (Basel, Switzerland) · 2026 · PubMed · doi:10.3390/diagnostics16030435
Findings
71 findings
| Population | ||||
|---|---|---|---|---|
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Iizuka 2005 | Proportion 0.97 [0.91, 0.99] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Shaw 2005 | Proportion 0.10 [0.07, 0.15] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wang 2021 | Proportion 0.88 [0.78, 0.93] GRADE not reported 6 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Radiotherapy group: radiotherapy | Proportion 0.69 [0.39, 0.89] GRADE not reported 4 studies · 89 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Kumar 2018 | Proportion 0.97 [0.91, 0.99] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Implant timing: primary | Proportion 1.00 [0.86, 1.00] GRADE not reported 1 study · 25 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Shen 2015 | Proportion 0.86 [0.79, 0.91] GRADE not reported 6 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Pellegrino 2018 | Proportion 0.90 [0.83, 0.94] GRADE not reported 6 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ewers 2025 | Proportion 0.98 [0.93, 1.00] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wang 2015 | Proportion 0.89 [0.79, 0.94] GRADE not reported 6 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Overall of radiotherapy subgroup analysis | Proportion 0.89 [0.71, 0.96] GRADE not reported 404 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Implant timing: simultaneous placement | Proportion 1.00 [1.00, 1.00] GRADE not reported 5 studies · 145 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Kovacs 2000 | Proportion 0.98 [0.91, 1.00] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Gbara 2007 | Proportion 0.08 [0.04, 0.13] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wiesli 2023 | Proportion 0.08 [0.04, 0.13] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Overall of radiotherapy subgroup analysis | Proportion 0.96 [0.92, 0.99] GRADE not reported 952 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ewers 2025 | Proportion 0.90 [0.81, 0.95] GRADE not reported 6 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Common-effect model | Proportion 0.101 [0.081, 0.124] GRADE not reported 10 studies · 776 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Radiotherapy group: radiotherapy | Proportion 0.97 [0.85, 1.00] GRADE not reported 4 studies · 93 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Gbara 2007 | Proportion 0.98 [0.91, 1.00] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wiesli 2023 | Proportion 0.98 [0.93, 1.00] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Overall of implant timing subgroup analysis | Proportion 0.99 [0.94, 1.00] GRADE not reported 531 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Overall of follow-up subgroup analysis | Proportion 0.98 [0.92, 0.99] GRADE not reported 952 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Cuellar 2021 | Proportion 0.86 [0.77, 0.92] GRADE not reported 6 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Implant timing: secondary placement | Proportion 0.96 [0.88, 1.00] GRADE not reported 7 studies · 386 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Shen 2015 | Proportion 0.97 [0.91, 0.99] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Follow-up >=60 months | Proportion 0.94 [0.81, 0.98] GRADE not reported 4 studies · 294 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ewers 2025 | Proportion 0.08 [0.06, 0.12] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Radiotherapy group: mixed or unclear | Proportion 0.90 [0.69, 1.00] GRADE not reported 3 studies · 298 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis | Proportion 0.979 [0.922, 0.994] Very low Downgraded: risk of bias, inconsistency, publication bias 13 studies · 952 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Sozzi 2017 | Proportion 0.98 [0.91, 1.00] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wang 2021 | Proportion 0.08 [0.05, 0.14] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis | Proportion 0.881 [0.803, 0.931] Very low Downgraded: risk of bias, inconsistency, publication bias 7 studies · 550 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Implant timing: secondary | Proportion 0.88 [0.79, 0.94] GRADE not reported 5 studies · 328 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Overall of implant timing subgroup analysis | Proportion 0.88 [0.81, 0.93] GRADE not reported 550 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wang 2015 | Proportion 0.97 [0.91, 0.99] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Pellegrino 2018 | Proportion 0.98 [0.93, 1.00] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ghana 2004 | Proportion 0.97 [0.91, 0.99] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis | Proportion 0.086 [0.052, 0.138] Very low Downgraded: risk of bias, inconsistency, indirectness 10 studies · 776 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Kumar 2018 | Proportion 0.08 [0.05, 0.14] GRADE not reported 9 studies |
| Patients with maxillomandibular defects reconstructed with vascularized free bone flaps | Dental implants placed in vascularized free bone flaps | None (single-arm pooled proportion) | Implant survival rate Mean follow-up at least 3 years (median 44.5 months) · Maxillomandibular reconstruction with vascularized free bone flaps · Follow-up <60 months | Proportion 0.99 [0.91, 1.0] GRADE not reported 9 studies · 658 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Shaw 2005 | Proportion 0.98 [0.93, 1.00] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ko 2024 | Proportion 0.09 [0.05, 0.15] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ko 2024 | Proportion 0.89 [0.79, 0.94] GRADE not reported 6 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wang 2015 | Proportion 0.08 [0.05, 0.13] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Sozzi 2017 | Proportion 0.10 [0.06, 0.15] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Chang 2014 | Proportion 0.97 [0.91, 0.99] GRADE not reported 12 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Radiotherapy group: no radiotherapy | Proportion 0.95 [0.81, 0.99] GRADE not reported 6 studies · 315 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Radiotherapy group: no radiotherapy | Proportion 0.98 [0.94, 1.00] GRADE not reported 10 studies · 561 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant success rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Implant timing: mixed | Proportion 0.82 [0.76, 0.87] GRADE not reported 2 studies · 197 participants |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Biological complication rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Kovacs 2000 | Proportion 0.09 [0.06, 0.15] GRADE not reported 9 studies |
| Patients with maxillomandibular reconstruction using vascularized free bone flaps | Dental implants placed in free bone flaps | None (single-arm proportion) | Implant survival rate Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Common-effect model | Proportion 0.915 [0.895, 0.931] GRADE not reported 13 studies · 952 participants |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ko 2024 | Proportion 0.12 [0.07, 0.19] GRADE not reported 6 studies |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Cuellar 2021 | Proportion 0.12 [0.04, 0.29] GRADE not reported 6 studies |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Pellegrino 2018 | Proportion 0.11 [0.04, 0.27] GRADE not reported 6 studies |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Kumar 2018 | Proportion 0.15 [0.10, 0.23] GRADE not reported 6 studies |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wang 2021 | Proportion 0.13 [0.08, 0.21] GRADE not reported 6 studies |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis | Proportion 0.137 [0.087, 0.210] Very low Downgraded: risk of bias, imprecision, indirectness 7 studies · 124 participants |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Sozzi 2017 | Proportion 0.15 [0.10, 0.23] GRADE not reported 6 studies |
| Implants in free bone flaps in patients who received radiotherapy | Dental implants placed in irradiated free bone flaps | None (single-arm proportion) | Implant failure rate with radiotherapy Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Chang 2014 | Proportion 0.14 [0.09, 0.21] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Common-effect model | OR 1.584 [0.814, 3.083] GRADE not reported 7 studies · 518 participants |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Wang 2021 | OR 3.35 [0.55, 20.37] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Pellegrino 2018 | OR 6.76 [2.04, 22.40] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Ko 2024 | OR 2.31 [0.43, 12.38] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Cuellar 2021 | OR 2.17 [0.48, 9.84] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis | OR 3.086 [0.714, 13.335] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 7 studies · 518 participants |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Kumar 2018 | OR 3.09 [0.71, 13.33] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Sozzi 2017 | OR 3.11 [0.55, 17.66] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Leave-one-out: omitting Chang 2014 | OR 3.09 [0.71, 13.33] GRADE not reported 6 studies |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure (second odds ratio analysis shown in Figure S5 file; unit of analysis not stated) Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis | OR 5.22 [1.49, 18.30] GRADE not reported 5 studies · 109 participants |
| Implants in free bone flaps in patients with and without radiotherapy | Radiotherapy | No radiotherapy | Implant failure (second odds ratio analysis shown in Figure S5 file; unit of analysis not stated) Follow-up of at least 3 years (median 44.5 months) · Maxillofacial reconstruction; implant level analysis · Common-effect model | OR 5.58 [1.69, 18.45] GRADE not reported 5 studies · 109 participants |
Included primary studies 16
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Shaw 2005 Oral rehabilitation after treatment for head and neck malignancy. PMID:15880417 | 2005 | 1 other review | not stated | not extracted yet |
| Chang 2014 Outcome of osseointegrated dental implants in double-barrel and vertically distracted fibula osteoseptocutaneous free flaps for segmental… PMID:25054246 | 2014 | this review only | not stated | not extracted yet |
| Cuellar 2021 Vertical Ridge Augmentation of Fibula Flap in Mandibular Reconstruction: A Comparison between Vertical Distraction, Double-Barrel Flap and… PMID:33396707 | 2020 | this review only | not stated | not extracted yet |
| Ewers 2025 Multicenter 14-year follow-up of fibula vascular grafts of mandibles and maxillae restored with short and extra-short implants. PMID:40318985 | 2025 | this review only | not stated | not extracted yet |
| Gbara 2007 Long-term results of jaw reconstruction with microsurgical fibula grafts and dental implants. PMID:17448854 | 2007 | this review only | not stated | not extracted yet |
| Ghana 2004 Segmental mandibulectomy and immediate free fibula osteoseptocutaneous flap reconstruction with endosteal implants: an ideal treatment… PMID:14707625 | 2004 | this review only | not stated | not extracted yet |
| Iizuka 2005 Oral rehabilitation after mandibular reconstruction using an osteocutaneous fibula free flap with endosseous implants. Factors affecting… PMID:15642033 | 2005 | this review only | not stated | not extracted yet |
| Ko 2024 The dental implant survival rate in 18 patients with post-operation revolutionary jaw reconstruction using free fibular flap, dental… PMID:39035273 | 2024 | this review only | not stated | not extracted yet |
| Kovacs 2000 Influence of the prosthetic restoration modality on bone loss around dental implants placed in vascularized iliac bone grafts for… PMID:11077348 | 2000 | this review only | not stated | not extracted yet |
| Kumar 2018 Masticatory efficiency of implant-supported removable partial dental prostheses in patients with free fibula flap reconstructed mandibles:… PMID:29920778 | 2018 | this review only | not stated | not extracted yet |
| Pellegrino 2018 Long-term results of osseointegrated implant-based dental rehabilitation in oncology patients reconstructed with a fibula free flap. PMID:30144257 | 2018 | this review only | not stated | not extracted yet |
| Shen 2015 Aesthetic and functional mandibular reconstruction with immediate dental implants in a free fibular flap and a low-profile reconstruction… PMID:24149408 | 2015 | this review only | not stated | not extracted yet |
| Sozzi 2017 Implant rehabilitation in fibula-free flap reconstruction: A retrospective study of cases at 1-18 years following surgery. PMID:28823690 | 2017 | this review only | not stated | not extracted yet |
| Wang 2015 Comparative analysis of dental implant treatment outcomes following mandibular reconstruction with double-barrel fibula bone grafting or… PMID:24299036 | 2015 | this review only | not stated | not extracted yet |
| Wang 2021 Thinned-out skin paddle versus collagen matrix as an optimized peri-implant soft tissue following fibula osteoseptocutaneous free flap:… PMID:32798162 | 2021 | this review only | not stated | not extracted yet |
| Wiesli 2023 Peri-implant Parameters of Dental Implants Inserted in Prefabricated Microvascular Fibular Flaps: A Retrospective Study. PMID:38085746 | 2023 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Survival rate and risk factors of implants in patients with head and neck neoplasms: a systematic review and meta-analysis. (2026) | 1 | 0.01 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients receiving dental implantation after maxillofacial reconstruction with vascularized free bone flaps (at least 10 patients) | 388 patients (16 studies) with vascularized free bone flap reconstruction; mostly fibula flaps (n=15 studies) |
| Intervention | Dental implants placed in vascularized free bone flaps; radiotherapy exposure | 1165 implants in free bone flaps; 137 implants in irradiated patients |
| Comparison | Not specified (single-arm proportions; radiotherapy versus no radiotherapy for the comparative analysis) | No radiotherapy (394 control implants in the comparative analysis) |
| Outcomes | Implant survival and success rate; biological complications; implant failure with radiotherapy; marginal bone loss, probing depth, bleeding index | Implant survival (13 studies, 952 implants); success (7 studies, 550); complication rate (10 studies, 776); failure with radiotherapy (7 studies, 124); radiotherapy odds ratio (7 studies) |
| Study designs | Original retrospective or prospective studies published in English | 14 retrospective and 2 prospective cohort studies |
| Timing | Minimum average follow-up of 3 years | Median follow-up 44.5 months |