Periimplant changes in different transplanted soft tissues around loaded endosseous implants in patients after oral tumor surgery.

PURPOSE: To examine periimplant reaction of transplanted soft tissues foreign to oral cavity when compared with local gingiva. METHODS: In 58 oral cancer patients, 210 dental implants were inserted mainly in the mandible after radical surgery and reconstruction. Ninety-six implants penetrated transplants (split skin, mucosal, platysma, pectoralis major, and intestinal) and were compared with 114 implants penetrating local gingiva. Prosthetic treatment consisted of telescopic or bar-retained overdentures or (in case of intestinal grafts) implant-supported fixed prostheses. Follow-up lasted between 30 and 60 months. Plaque index, sulcus bleeding index, pocket probing depth, and width of vestibular-/oral attached mucosa were measured. RESULTS: Plaque index (before second year; P < 0.01) and pocket probing depth (after first year; P < 0.02-0.04) displayed significant differences with disadvantage for split skin grafts. Sulcus bleeding did not exceed index 1. Attached mucosa had no significant effect on periimplant health. CONCLUSION: Transplanted extraoral tissues behaved similarly when compared with local gingiva, showing no detrimental effect on periimplant health in oral cancer patients. Split skin and mucosal grafts had worst performance.