FACE-Q outcomes following free fibular flap reconstruction with immediate dental implant placement

Background: Immediate dental implant placement (IDIP) is a novel technique that places endosseous dental implantation at the same time of ablative and reconstructive surgery, such as free fibular flap. This study aims to describe short- and long-term PROMs in patients undergoing IDIP using FACE-Q and to compare patients with and without complications.

Method: Data for patients who underwent IDIP and completed FACE-Q postoperatively were collected. Postoperative FACE-Q surveys were divided into three time-periods: perioperative (0-90 days), short-term (90-365 days), and long-term (1+ years). Complications included any minor and major (requiring operative management) complications.

Results: 70 patients underwent IDIP between November 2017 and January 2022 and completed FACE-Q postoperatively. We found no significance in scores between timepoints, although many domains, including facial function’s eating and drinking and speaking as well as quality of life’s speaking and drooling, show an upward trend. Patients with short-term complications reported significantly worse function in eating and drinking, oral competence, speaking, and swallowing as well as distress in eating and speaking than those without complications (p<0.05). Lastly, there were significant differences in eating and drinking, oral competence, and swallowing of the facial function domain between patients with and without long-term complications (p<0.05).

Conclusion: In our study, we evaluated PROMs for patients who have undergone IDIP. We found that FACE-Q scores are responsive to patients’ clinical states as patients perform generally better over time and complications can worsen PROMs. We highly encourage other institutions to administer PROMs for such unique patient populations using tools like FACE-Q.