Abstract
From April 2002 to March 2013, we conducted reconstructive surgery in 33 patients who underwent maxillary and mandibular resection or who had complications from head and neck cancer.
Overall, 19 patients were treated by a fibular osteocutaneous free flap for a maxillar or mandibular bone defect, 8 patients received a reconstructive titanium plate for the mandible and 6 patients were reconstructed by soft tissue transfer only. In the fibular group, 3 patients had an additional operation to install osseointegrated implants into the transferred bone (for the mandible in two patients and the maxilla in one patient).
In the fibular bone group, 4 patients could wear an ordinary denture and three patients could successfully wear a special denture based on the installed implants.
In the ordinary denture group, one patient needed to remove the denture while eating and used it only for esthetics. The other patients could use the denture both for esthetics and while eating, but they tended to chew food on the unaffected side of the maxilla or mandible.
In the implant denture group, one patient could chew on both sides of the mandible and the other two tended to chew only on the unaffected side.
It is thought that wearing a denture could provide esthetic value and improve masticatory function on the unaffected oral side, and the implant denture could provide stability for the denture apparatus.
The Japanese government has recently allowed osseointegrated implants and a special denture attached to them to be covered by national health insurance. As a result, implant dentures accompanied with bone grafts will become widely used for head and neck cancer patients. For the future, we must evaluate its quality for not only masticatory function of the affected side, but also total masticatory function, esthetics and psychological function.
