Factors Affecting Survival Rate Of Immediate Osseointegrated Implant In Mandibular Reconstruction With Fibula Free Flaps

Objective: Vascularized fibular flap combined with IOI placement is the mainstream direction for functional reconstruction of mandibular defects.The purpose of this study is to analysis the factors affecting the survival rate of IOI,in patients required mandibular function reconstruction with vascularized fibular flap,by the way of Meta-analysis and systematic,so as to provide a basis for the clinical application of IOI.Methods: Pubmed,Embase,Web of science,Cochrane Library and CNKI databases were searched to find relevant literature on vascularized fibular flap combined with IOI for mandibular functional reconstruction.The retrieval time was from 1989 to 2019.Results: A total of thirteen literatures with 1391 implants were included in this study.The differences of IOI survival rates in the various factors were divided into multiple subgroups to analysis.In the analysis of Gender,Age and Tumor nature,there was no significant difference in implant survival rate between experimental group and the control group.OR=1.83(95%CI=0.54,6.23);OR=0.66(95%CI=0.23,1.88);OR=0.45(95%CI=0.17,1.23).The survival rate of IOI in Radiotherapy group was significantly lower than that in nonRadiotherapy group,OR=3.73(95%CI=1.92,7.27).Sensitivity analysis suggests that the overall evaluation of the included literature is relatively stable.Conclusion: Meta-analysis showed that radiotherapy could reduce the survival rate of IOI.There was no correlation between Gender,Age,and Tumor nature of patients with the survival rate of IOI.In the literature review,there was no significant correction between HBO,BPs and the survival rate of IOI.The increase of radiation dose and without perimplant tissue reconstruction may reduce the survival rate of IOI.More relevant studies are needed to further clarify the factors affecting the survival rate of IOI after mandibular reconstruction with VFF.