Functional maxilla-mandibular reconstruction using dental implant

Abstract

Various kinds of reconstructive procedures for maxillary and mandibular bony defects have been reported. In oncologic surgery, it could be difficult to reconstruct the maxillo-mandible because bony defects are usually long, both bony and soft tissue defects often remain and avascular problems at the recipient site due to multiple surgeries included neck dissection or irradiation. Moreover, it is well known that denture fabrication is difficult because of loss of the alveolar ridge in edentulous patients. Based on these reasons, a dental implant was introduced for denture stability in the reconstructed bone. Forty-one implants, in 8 patients, in reconstructed bones by the revascularized fibular osteoseptcutaneous flap since October 1992 have been retrospectively discussed. As for the results of these surgeries, only 3 implants placed in the same patient have failed and the success rate is 92.4%. These 3 implants were installed again 6 months later. Concerning the timing of dental implant placement, 3 patients had implants placed at the same time as reconstruction of the maxillo-mandible and the other 5 were secondarily placed from 6 to 12 months after reconstruction. As for the superstructures fabricated, one was a screw on denture system and the others were removable denture systems connected with several kinds of attachments. Treatment using dental implants for reconstructed maxilla-mandibles following oral cancer ablation has been covered by Japanese public health insurance since 2012.