The clinical outcome of dental implants placed through skin flaps

Abstract

Objective and study design: The incidence of peri-implantitis, marginal bone loss, implant success, and survival rates of 52 dental implants placed through the skin paddle and 23 implants through the neighboring gingiva were investigated. Mixed linear model was adopted to analyze the influence of radiation and skin paddle on marginal bone loss and peri-implantitis.

Results: The incidence of peri-implantitis in implants placed through the skin flaps was higher (32.7%) than that of implants placed through the oral mucosa (8.7%). According to the mixed linear analysis, no significant difference in the amount of marginal bone loss was observed between the 2 groups: implants placed through the skin graft had marginal bone loss of 0.39 ± 0.14 mm at 1 year and 0.50 ± 0.23 mm at 5 years, and implants placed through the oral mucosa had marginal bone loss of 0.32 ± 0.12 mm and 0.52 ± 0.21 mm at the same time intervals. The 1-year and 2- to 5-year cumulative survival rates of the implants placed through the skin were 100% and 98%, respectively, and those of implants placed through the oral mucosa were both 95.65%. The 1-year and 2- to 5-year cumulative success rates of the implants placed through the skin were 92.30% and 79.38%, respectively, and those of implants placed through the oral mucosa were 91.30% and 82.59%, respectively.

Conclusion: Implants can be successfully placed and maintained in lining defects covered with a skin paddle; hence, this treatment modality may be considered reasonable and reliable for the functional and aesthetic rehabilitation of patients with oromaxillofacial reconstructions.

Keywords: implant through skin paddle; marginal bone loss; mucosal lining defect; oromandibular reconstruction; peri-implantitis; transcutaneous implant; transmucosal implant.