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The Modified Alberta Reconstructive Technique: A prospective cohort study.

Justin M Pyne1, Brendan C Kelly1, Heather Logan2

  • 1University of Alberta - Division of Otolaryngology-Head and Neck Surgery, University of Alberta Hospital, 8440 112 Street NW, Edmonton, Alberta T6G 2B7, Canada.

Oral Oncology
|February 26, 2022
PubMed
Summary

The Modified Alberta Reconstruction Technique (MART) offers improved aesthetics and better soft tissue control for jaw defect reconstructions with dental implants compared to older methods. This safe and effective procedure enhances functional outcomes and patient satisfaction.

Keywords:
Dental rehabilitationHead and neck cancerJaw reconstructionOral cancerSurgical design and simulation

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Reconstructive Surgery
  • Dental Implantology

Background:

  • Free tissue transfer with vascularized bone and osseointegrated dental implants has revolutionized jaw defect reconstruction.
  • The Alberta Reconstructive Technique (ART) and conventional bone-donated defect (BDD) reconstructions are established methods.
  • A novel modification, the Modified Alberta Reconstruction Technique (MART), was developed to potentially improve outcomes.

Purpose of the Study:

  • To evaluate the soft tissue component and overall outcomes of the MART.
  • To compare MART with the ART and BDD techniques in terms of functional and aesthetic results.
  • To assess the clinical utility and patient-centered benefits of the MART modification.

Main Methods:

  • A prospective cohort study included 46 adult patients undergoing jaw reconstruction with dental implants (2000-2019).
  • Patients were age-matched into three groups: BDD (n=15), ART (n=15), and MART (n=16).
  • Outcomes, including complications, soft tissue quality, and aesthetics, were analyzed using expert and statistical assessments.

Main Results:

  • No significant differences in complication rates were observed between the BDD, ART, and MART groups.
  • The soft tissue component in the MART cohort was judged more favorable for occlusal reconstruction by experts.
  • The MART procedure demonstrated superior aesthetic appeal compared to both BDD and ART (p=0.049).

Conclusions:

  • The MART is a safe, effective, and aesthetically pleasing option for jaw reconstruction.
  • It provides favorable functional results and improved soft tissue management around dental implants.
  • MART is an ideal choice for select patients needing jaw reconstruction, offering enhanced control of the soft tissue environment.