Postradiotherapy Prosthetic Management of Mandible Reconstructed With Fibular Graft

Intraoral defects secondary to resection of mandible leading to mandibular discontinuity are very complicated to treat as the muscles exert forces on the residual portion of the mandible. Primarily this leads to disfigurement of the face. These forces also make mastication difficult due to imbalance. Ultimately it leads to poor quality of life for the patient. Apart from that the clinical outcome and prognosis of prosthetic rehabilitation of such patients is very poor. The composite fibular flap is the preferred donor site for reconstruction of most complex orofacial-mandibular defects. The addition of a skin island allows for absolute tension-free intraoral closure that enhances tongue mobility. After reconstruction with free fibula graft, planning for prosthodontic rehabilitation by various methods can be carried out. Treatment strategy is dependent on the intraoral situation and patient's acceptance. This article reports various treatment considerations for implant retained prosthetic rehabilitation in a patient who had undergone mandibular reconstruction with free fibula flap.