{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:20:01Z","timestamp":1789057201116,"version":"build-2803163510"},"reference-count":52,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ijoms.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Oral and Maxillofacial Surgery"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.ijom.2025.06.011","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T07:30:42Z","timestamp":1750404642000},"page":"94-109","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and dental implant outcomes in patients after mandibular continuity reconstruction with bone flaps versus bone grafts: a systematic review and meta-analysis"],"prefix":"10.1016","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7896-8909","authenticated-orcid":false,"given":"B.C.","family":"Mendes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.S.","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4951-5836","authenticated-orcid":false,"given":"M.T.V.","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.F.","family":"Santiago Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Hochuli-Vieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2249-3048","authenticated-orcid":false,"given":"L.P.","family":"Faverani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijom.2025.06.011_bib1","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/S0278-2391(99)90015-0","article-title":"Comparison of the late results of mandibular reconstruction using nonvascularized or vascularized grafts and dental implants","volume":"57","author":"Schliephake","year":"1999","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s10006-020-00839-6","article-title":"Full-staged digital and prosthetic guided protocol for the insertion of dental implants in autogenous free bone grafts after reconstruction of segmental mandibular defects","volume":"24","author":"Mounir","year":"2020","journal-title":"Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/(SICI)1097-0347(199901)21:1<66::AID-HED9>3.0.CO;2-Z","article-title":"Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: an outcome analysis of primary bony union and endosseous implant success","volume":"21","author":"Foster","year":"1999","journal-title":"Head Neck"},{"key":"10.1016\/j.ijom.2025.06.011_bib4","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/S0278-2391(97)90165-8","article-title":"A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects","volume":"55","author":"Pogrel","year":"1997","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib5","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1016\/j.joms.2008.12.052","article-title":"Nonvascularized bone grafts for segmental reconstruction of the mandible\u2014a reappraisal","volume":"67","author":"van Gemert","year":"2009","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib6","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1016\/j.joms.2011.08.024","article-title":"Free vascularized flaps for reconstruction of the mandible: complications, success, and dental rehabilitation","volume":"70","author":"van Gemert","year":"2012","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib7","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/j.ijom.2016.05.004","article-title":"Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review","volume":"45","author":"Moura","year":"2016","journal-title":"Int J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib8","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1055\/s-0036-1597583","article-title":"Free bone grafts for mandibular reconstruction in patients who have not received radiotherapy: the 6-cm rule\u2014myth or reality?","volume":"10","author":"Nandra","year":"2017","journal-title":"Craniomaxillofac Trauma Reconstr"},{"key":"10.1016\/j.ijom.2025.06.011_bib9","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.jclinepi.2009.06.005","article-title":"PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"62","author":"Moher","year":"2009","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.ijom.2025.06.011_bib10","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1016\/j.ijom.2016.09.023","article-title":"Maxillary sinus lift surgery\u2014with or without graft material? A systematic review","volume":"45","author":"Silva","year":"2016","journal-title":"Int J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib11","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.ijom.2025.06.011_bib12","series-title":"How to use the evidence: assessment and application of scientific evidence","author":"National Health and Medical Research Council","year":"2000"},{"key":"10.1016\/j.ijom.2025.06.011_bib13","doi-asserted-by":"crossref","first-page":"3914","DOI":"10.3390\/ma13183914","article-title":"Is there a role for absorbable metals in surgery? A systematic review and meta-analysis of Mg\/Mg alloy based implants","volume":"13","author":"Sukotjo","year":"2020","journal-title":"Materials ((Basel))"},{"key":"10.1016\/j.ijom.2025.06.011_bib14","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1111\/odi.12916","article-title":"Surgical versus non-surgical treatment of actinic cheilitis: a systematic review and meta-analysis","volume":"25","author":"Carvalho","year":"2019","journal-title":"Oral Dis"},{"key":"10.1016\/j.ijom.2025.06.011_bib15","series-title":"Introduction to meta-analysis","author":"Borenstein","year":"2009"},{"key":"10.1016\/j.ijom.2025.06.011_bib16","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.ijom.2015.11.009","article-title":"Platform-switching implants and bone preservation: a systematic review and meta-analysis","volume":"45","author":"Santiago","year":"2016","journal-title":"Int J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib17","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.ijom.2017.05.021","article-title":"Dental implants in patients with osteoporosis: a systematic review with meta-analysis","volume":"47","author":"de Medeiros","year":"2018","journal-title":"Int J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib18","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1111\/j.1600-051X.2012.01930.x","article-title":"Periimplant marginal bone level: a systematic review and meta-analysis of studies comparing platform switching versus conventionally restored implants","volume":"39","author":"Annibali","year":"2012","journal-title":"J Clin Periodontol"},{"key":"10.1016\/j.ijom.2025.06.011_bib19","series-title":"Cochrane handbook for systematic reviews of interventions version 6.0 (updated July 2019)","article-title":"Chapter 10: Analysing data and undertaking meta-analyses","author":"Deeks","year":"2019"},{"key":"10.1016\/j.ijom.2025.06.011_bib20","first-page":"371","article-title":"Computer-assisted implant rehabilitation of maxillomandibular defects reconstructed with vascularized bone free flaps","volume":"139","author":"Okay","year":"2013"},{"key":"10.1016\/j.ijom.2025.06.011_bib21","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1016\/j.jcms.2016.09.011","article-title":"Intraosseous stability of dental implants in free revascularized fibula and iliac crest bone flaps","volume":"44","author":"M\u00f6hlhenrich","year":"2016","journal-title":"J Craniomaxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib22","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1600-0501.2004.01076.x","article-title":"Oral rehabilitation after mandibular reconstruction using an osteocutaneous fibula free flap with endosseous implants. Factors affecting the functional outcome in patients with oral cancer","volume":"16","author":"Iizuka","year":"2005","journal-title":"Clin Oral Implants Res"},{"key":"10.1016\/j.ijom.2025.06.011_bib23","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1067\/mhn.2000.107317","article-title":"Influence of the prosthetic restoration modality on bone loss around dental implants placed in vascularized iliac bone grafts for mandibular reconstruction","volume":"123","author":"Kov\u00e1cs","year":"2000","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib24","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1097\/SCS.0000000000003841","article-title":"Occlusion guided double-barreled fibular osteoseptocutaneous free flap for refined mandibular reconstruction aided by virtual surgical planning","volume":"28","author":"Qu","year":"2017","journal-title":"J Craniofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib25","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1016\/S0278-2391(03)00726-2","article-title":"Dental implants in reconstructed jaws: implant longevity and peri-implant tissue outcomes","volume":"61","author":"Cheung","year":"2003","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib26","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1034\/j.1600-0501.2000.011001066.x","article-title":"Behavior of implants in bone grafts or free flaps after tumor resection","volume":"11","author":"Chiapasco","year":"2000","journal-title":"Clin Oral Implants Res"},{"key":"10.1016\/j.ijom.2025.06.011_bib27","first-page":"767","article-title":"Endosseous implant and autogenous bone graft reconstruction of mandibular discontinuity: a 12-year longitudinal study of 31 patients","volume":"13","author":"Keller","year":"1998","journal-title":"Int J Oral Maxillofac Implants"},{"key":"10.1016\/j.ijom.2025.06.011_bib28","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1159\/000229027","article-title":"Functional rehabilitation of mandibular continuity defects using autologous bone and dental implants\u2014prognostic value of bone origin, radiation therapy and implant dimensions","volume":"43","author":"Klein","year":"2009","journal-title":"Eur Surg Res"},{"key":"10.1016\/j.ijom.2025.06.011_bib29","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1111\/j.1600-0501.2008.01542.x","article-title":"Long-term results of mandibular reconstruction with autogenous bone grafts and oral implants after tumor resection","volume":"19","author":"Chiapasco","year":"2008","journal-title":"Clin Oral Implants Res"},{"key":"10.1016\/j.ijom.2025.06.011_bib30","doi-asserted-by":"crossref","first-page":"863e","DOI":"10.1097\/PRS.0000000000009540","article-title":"Dental implant outcomes in fibula mandible reconstruction with or without vertical distraction for symphysis cross-arch segmental defects","volume":"150","author":"Chen","year":"2022","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib31","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/0278-2391(95)90158-2","article-title":"Evaluation of osseointegration of endosseous implants in radiated, vascularized fibula flaps to the mandible: a pilot study","volume":"53","author":"Barber","year":"1995","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib32","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1097\/SCS.0000000000005015","article-title":"The treatment of lower jaw defects using vascularized fibula graft and dental implants","volume":"29","author":"Khachatryan","year":"2018","journal-title":"J Craniofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib33","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.joms.2009.09.104","article-title":"Clinical evaluation of implants in radiated fibula flaps","volume":"68","author":"Salinas","year":"2010","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib34","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.joms.2018.08.008","article-title":"Functional mandibular reconstruction with double-barrel fibular flap and primary osseointegrated dental implants improve facial esthetic outcome","volume":"77","author":"Chen","year":"2019","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib35","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1111\/cid.12169","article-title":"Autologous ilium grafts: long-term results on immediate or staged functional rehabilitation of mandibular segmental defects using dental implants after tumor resection","volume":"17","author":"Zou","year":"2015","journal-title":"Clin Implant Dent Relat Res"},{"key":"10.1016\/j.ijom.2025.06.011_bib36","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s11845-013-0921-2","article-title":"Deep circumflex iliac artery flap with osseointegrated implants for reconstruction of mandibular benign lesions: clinical experience of 33 cases","volume":"182","author":"Qu","year":"2013","journal-title":"Ir J Med Sci"},{"key":"10.1016\/j.ijom.2025.06.011_bib37","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1097\/PRS.0b013e318230c6a9","article-title":"Dental implant outcome after primary implantation into double-barreled fibula osteoseptocutaneous free flap-reconstructed mandible","volume":"128","author":"Chang","year":"2011","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib38","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1001\/jamafacial.2015.2271","article-title":"Evaluation of clinical outcomes of osseointegrated dental implantation of fibula free flaps for mandibular reconstruction","volume":"18","author":"Jackson","year":"2016","journal-title":"JAMA Facial Plast Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib39","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/cid.12870","article-title":"Immediate dental implants in fibula free flaps to reconstruct the mandible: a pilot study of the short-term effects on radiotherapy for patients with head and neck cancer","volume":"22","author":"Sandoval","year":"2020","journal-title":"Clin Implant Dent Relat Res"},{"key":"10.1016\/j.ijom.2025.06.011_bib40","doi-asserted-by":"crossref","first-page":"169","DOI":"10.11607\/jomi.3606","article-title":"Long-term results of mandibular reconstruction of continuity defects with fibula free flap and implant-borne dental rehabilitation","volume":"30","author":"Fang","year":"2015","journal-title":"Int J Oral Maxillofac Implants"},{"key":"10.1016\/j.ijom.2025.06.011_bib41","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/cid.13011","article-title":"Assessment of bone density and stability with immediately loaded dental implants with the All-on-Four technique in free vascularized fibular grafts used for mandibular reconstruction","volume":"23","author":"Shawky","year":"2021","journal-title":"Clin Implant Dent Relat Res"},{"key":"10.1016\/j.ijom.2025.06.011_bib42","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/jamafacial.2018.0263","article-title":"Primary vs secondary endosseous implantation after fibular free tissue reconstruction of the mandible for osteoradionecrosis","volume":"20","author":"Menapace","year":"2018","journal-title":"JAMA Facial Plast Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib43","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1016\/j.jcms.2016.08.023","article-title":"Implants in free fibula flap supporting dental rehabilitation\u2014implant and peri-implant related outcomes of a randomized clinical trial","volume":"44","author":"Kumar","year":"2016","journal-title":"J Craniomaxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib44","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1016\/j.jcms.2017.06.021","article-title":"Implant rehabilitation in fibula-free flap reconstruction: a retrospective study of cases at 1\u201318 years following surgery","volume":"45","author":"Sozzi","year":"2017","journal-title":"J Craniomaxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib45","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1097\/SCS.0b013e3181bec611","article-title":"Microsurgical reconstruction of the jaw with fibular grafts and implants","volume":"20","author":"Raoul","year":"2009","journal-title":"J Craniofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib46","first-page":"11","article-title":"The long-term efficacy of currently used dental implants: a review and proposed criteria of success","volume":"1","author":"Albrektsson","year":"1986","journal-title":"Int J Oral Maxillofac Implants"},{"key":"10.1016\/j.ijom.2025.06.011_bib47","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/0022-3913(89)90081-4","article-title":"Criteria for success of osseointegrated endosseous implants","volume":"62","author":"Smith","year":"1989","journal-title":"J Prosthet Dent"},{"key":"10.1016\/j.ijom.2025.06.011_bib48","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.joms.2014.10.019","article-title":"Is immediate reconstruction of the mandible with nonvascularized bone graft following resection of benign pathology a viable treatment option?","volume":"73","author":"Schlieve","year":"2015","journal-title":"J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib49","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0901-5027(96)80004-X","article-title":"Oral rehabilitation with endosteal implants and free flaps","volume":"25","author":"Hayter","year":"1996","journal-title":"Int J Oral Maxillofac Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib50","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/00006534-198907000-00014","article-title":"Fibula free flap: a new method of mandible reconstruction","volume":"84","author":"Hidalgo","year":"1989","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib51","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/00006534-197505000-00002","article-title":"The free vascularized bone graft. A clinical extension of microvascular techniques","volume":"55","author":"Taylor","year":"1975","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.ijom.2025.06.011_bib52","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.tripleo.2009.10.001","article-title":"Radiation effects on bone healing and reconstruction: interpretation of the literature","volume":"109","author":"Jegoux","year":"2010","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"}],"container-title":["International Journal of Oral and Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S090150272501330X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S090150272501330X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:25:06Z","timestamp":1766517906000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S090150272501330X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":52,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["S090150272501330X"],"URL":"https:\/\/doi.org\/10.1016\/j.ijom.2025.06.011","relation":{},"ISSN":["0901-5027"],"issn-type":[{"value":"0901-5027","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Clinical and dental implant outcomes in patients after mandibular continuity reconstruction with bone flaps versus bone grafts: a systematic review and meta-analysis","name":"articletitle","label":"Article Title"},{"value":"International Journal of Oral and Maxillofacial Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijom.2025.06.011","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}