Prosthetic Rehabilitation Options in Post-Ablative Maxillomandibular Microvascular Reconstructions

Surgery remains the mainstay for managing most neoplasms arising in the head and neck area. Removable or fixed prostheses are commonly used for prosthetic rehabilitation of head and neck defects following surgical resection. Some major challenges in prosthetic rehabilitation after maxillomandibular microvascular reconstruction include excessive prosthetic space, soft tissue bulk, and occlusal disharmony in the remaining dentition. This review focuses on the challenges we have experienced in the real clinical scenario while rehabilitating reconstructed maxillomandibular defects and the effective prosthetic treatment options that could be considered in each situation.

Digital revolution has changed all arenas of life, and it has created a significant impact on cancer treatment planning and the delivery of quality treatment to the needy. Creating adequate retention while ensuring stability and support for the prosthesis can be challenging with temporary acrylic and cast partial removable dentures. Endosseous dental implants are considered a stable, reliable, and esthetic option for reconstruction with advantages such as increased chewing efficiency, preservation of the remaining bone height and width, and improved quality of life. The FP3 to RP5 (Misch's classification) are some commonly followed prosthetic rehabilitation options after microvascular reconstruction. The prosthetic design should permit the usage of interdental aids that ensure the longevity of prostheses.

Occlusion-driven/prosthetic-driven implant-assisted prostheses are considered a reliable option that ensures stable and functional oral rehabilitation among patients with free fibula flap reconstruction. Multidisciplinary teamwork is mandatory for an optimal outcome that improves patients' quality of life.