Dental Prosthetic Rehabilitation in Mandibular Reconstruction: Optimizing Timing and Patient Selection.

Abstract

Background: Dental prosthetic rehabilitation (DPR) plays a critical role in restoring function and quality of life following mandibular reconstruction. This study examines the rate of patients undergoing dental implants and DPR after reconstruction of a segmental jaw defect with a fibula free flap reconstruction. We identify factors associated with successful dental implants and DPR in this patient population.

Methods: Retrospective review examining the rate of dental implants and DPR in fibula free flaps at a tertiary academic hospital.

Results: Of the 67 patients, 34 did not undergo dental implants at the time of reconstruction, 33 underwent primary dental implants, with 19 of these patients undergoing implants alone with a plan for later prosthesis and 14 (20.9%) getting immediate implants with provisional prosthesis-referred to as jaw in a day (JIAD). Implants were placed with a success rate of 89.3% for implants alone and 94.0% for JIAD patients. None of the 34 patients who did not receive dental implants at the time of reconstruction later underwent dental implants or DPR. In contrast, of those who underwent dental implants without the placement of a provisional prosthesis, 63.2% (12/19) successfully obtained a final prosthesis. In patients who underwent JIAD, 92.8% (13/14) went on to get a final dental prosthesis.

Conclusion: Our study demonstrates that immediate placement of dental implants with or without a tissue-borne prosthesis during mandibular reconstruction can be performed with a high rate of success. Furthermore, our data suggest that immediate placement of a dental prosthesis is the most efficient method of achieving dental rehabilitation.

Level of evidence: 3: