Prosthetic reconstruction for oral cancer patients using dental implants

Abstract

Prosthetic reconstruction for patients who had ablative head and neck tumor surgery is still challenging because both soft and hard tissues are required. Use of dental implants in oral cancer reconstruction has become an important aspect of the reconstructive plan for these patients. For the mandibular defects, first, the continuity of the mandible should be restored according to tissue condition. In severe cases, free flap transfer should be performed. Relatively short segments or benign tumors with sufficient vascularity could possibly be treated with the bone-grafting procedure with particulate cancellous bone marrow (PCBM) combined with titanium mesh (PCBM- MESH). Second, facial contours and the final dental occlusion are simulated to determine the optimal base of the dental implant or conventional dentures. The final prosthetic treatment requires an intra-oral environment for the prosthesis, particularly enough alveolar ridge with good and healthy soft tissue around the prosthesis. For this purpose, PCBM-MESH is a useful technique to link between optimum facial contour and alveolar reconstruction. Local tissue management including thinning of the skin paddle and/or vestibuloplasty is often required. The choice of prosthesis depends on the condition of the reconstruction, the remaining dentition, the maxilla–mandibular relationship, and other factors.