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

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Reconstructive Surgery

Background:

• Dental prosthetic rehabilitation (DPR) is crucial for function and quality of life after mandibular reconstruction.
• Fibula free flap reconstruction is a common method for segmental jaw defects.
• Assessing dental implant and DPR success post-reconstruction is vital.

Purpose of the Study:

• To examine the rate of dental implants and DPR following fibula free flap mandibular reconstruction.
• To identify factors influencing successful dental implant and DPR outcomes.
• To evaluate the efficacy of immediate versus delayed prosthetic rehabilitation.

Main Methods:

• Retrospective review of patients undergoing fibula free flap reconstruction at a tertiary academic hospital.
• Analysis of dental implant placement rates and subsequent DPR.
• Comparison of outcomes for immediate implants with provisional prosthesis (JIAD) versus implants alone.

Main Results:

• 33 of 67 patients received primary dental implants; 14 underwent immediate implants with provisional prosthesis (JIAD).
• Implant success rates were 89.3% for implants alone and 94.0% for JIAD.
• JIAD patients had a higher rate of final prosthesis success (92.8%) compared to implants alone (63.2%).
• Patients not receiving implants at reconstruction did not undergo later DPR.

Conclusions:

• Immediate dental implant placement, with or without a prosthesis, is successful in mandibular reconstruction.
• Immediate prosthetic placement is the most efficient method for dental rehabilitation.
• This approach significantly improves functional and aesthetic outcomes post-jaw reconstruction.