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Video

Head and Neck Surgery

(A513) Building a Successful Head and Neck Osteocutaneous Free Flap Dental Restoration Program

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Nikhil Bellamkonda, MD

    Resident Physician
    University of Utah
    Salt Lake City, Utah, United States

    • Co-Author(s)

  • SN

    Samuel Nelson, BS

    University of Utah, United States

  • Nilam D. Patel, MD

    Assistant Professor of Otolaryngology-Head and Neck Surgery
    University Hospitals Cleveland Medical Center/Case Western Reserve University
    Elgin, IL, United States

  • RT

    Rhet Tucker, DMD

    Maxillofacial Prosthodontist
    University of Utah
    Salt Lake City, UT, United States

  • Richard B. Cannon, MD

    Assistant Professor
    University of Utah - Department of Otolaryngology - Head and Neck Surgery
    Salt Lake City, Utah, United States

  • da

    david adams, DDS

    University of Utah, United States

    • Senior Author(s)

  • HM

    Hilary C. McCrary, MD, MPH

    Assistant Professor of Otolaryngology-Head and Neck Surgery
    University of Utah - Department of Otolaryngology - Head and Neck Surgery
    Salt Lake City, Utah, United States

Disclosure(s):
Nikhil Bellamkonda, MD: No relevant relationships to disclose.
Nilam D. Patel, MD: No relevant relationships to disclose.
Rhet Tucker, DMD: No relevant relationships to disclose.
Hilary C. McCrary, MD, MPH: No relevant relationships to disclose.


Introduction: Immediate dental implantation in patients undergoing osteocutaneous free flap reconstruction for head and neck surgical defects can greatly improve patients’ quality of life and increases the likelihood that patients will undergo dental restoration. A successful dental restoration program requires interdisciplinary coordination and access to virtual surgical planning or the technical skills to perform free-hand implantation.

Methods: This study evaluated the first year of an immediate dental implantation program at a single high-volume center. Patients who underwent concomitant osteocutaneous free flap to the head and neck with immediate dental implantation between November 2023 and October 2024 were reviewed.

Results: A total of 28 patients were included. The median age was 58 (range: 9 - 85) years old. Twenty (71%) patients had surgery for head and neck cancer, four (14%) for osteoradionecrosis, three (11%) for craniofacial trauma, and one (3.5%) for osteomyelitis. Twenty (71%) had mandible reconstruction and eight (29%) had maxilla reconstruction. Virtual surgical planning was utilized in 18 (64%) patients. A fibular free flap was utilized in the majority (26, 93%) of patients, while two (7%) had a scapula free flap. The median number of implants placed was two (range: 1-5). Among all patients, three (11%) had vascular anastomosis failure; one was salvaged. Two had skin paddle necrosis, but viable underlying soft tissue and bone. One (3.5%) patient had one of three implants fail.

Ten patients so far have had a second-stage vestibuloplasty for dental implant exposure (on average four months after their initial surgery); among them, eight are awaiting prosthesis manufacturing and two have completed successful restoration.

Conclusions: Coordination between head & neck microvascular and oral & maxillofacial surgeons allowed for dental implantation of 28 patients within a year of a new and growing dental restoration program. With a multidisciplinary approach, immediate dental restoration can be successfully completed.