Fibula free flap reconstruction of the mandible in cancer patients: Evaluation of a combined surgical and prosthodontic treatment concept

Smolka, Koord; Kraehenbuehl, Michel; Eggensperger, Nicole; Hallermann, Wock; Thoren, Hanna; Iizuka, Tateyuki; Smolka, Wenko (2007). Fibula free flap reconstruction of the mandible in cancer patients: Evaluation of a combined surgical and prosthodontic treatment concept. Oral oncology, 44(6), pp. 571-581. Amsterdam: Elsevier 10.1016/j.oraloncology.2007.07.005

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The final goal of mandibular reconstruction following ablative surgery for oral cancer is often considered to be dental implant-supported oral rehabilitation, for which bone grafts should ideally be placed in a suitable position taking subsequent prosthetic restoration into account. The aim of this study was to evaluate the efficacy of a standardized treatment strategy for mandibular reconstruction according to the size of the bony defect and planned subsequent dental prosthetic rehabilitation. Data of 56 patients, who had undergone such a systematic mandibular fibula free flap reconstruction, were retrospectively analyzed. Early complications were observed in 41.5% of the patients but only in those who had been irradiated. Late complications were found in 38.2%. Dental implant survival rate was 92%, and dental prosthetic treatment has been completed in all classes of bony defects with an overall success rate of 42.9%. The main reasons for failure of the complete dental reconstruction were patients' poor cooperation (30.4%) and tumour recurrence (14.3%) followed by surgery-related factors (10.8%) such as implant failure and an unfavourable intermaxillary relationship between the maxilla and the mandible. A comparison of our results with the literature findings revealed no marked differences in the complication rates and implant survival rates. However, a systematic concept for the reconstructive treatment like the method presented here, plays an important role in the successful completion of dental reconstruction. The success rate could still be improved by some technical progress in implant and bone graft positioning.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Craniomaxillofacial Surgery
UniBE Contributor:	Smolka, Koord Maximilian Wilke, Eggensperger, Nicole, Hallermann, Wock Fritz, Thoren, Hanna Agneta, Iizuka, Tateyuki, Smolka, Wenko
ISSN:	1368-8375
ISBN:	17938001
Publisher:	Elsevier
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:56
Last Modified:	05 Dec 2022 14:17
Publisher DOI:	10.1016/j.oraloncology.2007.07.005
PubMed ID:	17938001
Web of Science ID:	000256746100007
URI:	https://boris.unibe.ch/id/eprint/23764 (FactScience: 44315)