2019 Volume 32 Issue 3 Pages 230-235
After mandibular bone segmental resection for tumor treatment, the mandible is usually reconstructed with autogenous bone, such fibula or iliac bone. However, in cases where reconstruction cannot be done with a plate alone due to defect size or diagnosis, age is a consideration. It is extremely difficult to cover the flap of such patients with a removable prosthesis. We report our experience with a case of edentulous jaw that was reconstructed with a plate alone after a mandibular unilateral resection for carcinoma with a good long-term function in an implant overlay denture.
The patient was a 74-year-old woman who underwent primary reconstruction with a delto-pectoral (D-P) flap after hemimandibular segmental resection for the treatment of carcinoma of the lower gum. Two years later, she opted not to undergo secondary reconstruction with fibula or iliac bone because she wanted to run marathons as that was her hobby ; therefore, we used only a plate for the secondary reconstruction. She had been able to eat extremely soft food with complete dentures, but always complained of mucosal pain in the residual bone stump. Therefore, we placed one implant, an overlay denture, in the stump part of the existing alveolar ridge. After implantation of the overlay denture, her mucosal pain disappeared, and she was able to eat a wider range of foods. She maintained good masticatory function for 12 years, with no ulcer development in the flap on the reconstruction plate. Furthermore, the mucosa around the implant showed no sign of infection, and radiographs demonstrated no resorption of bone. Her oral health-related quality of life remained high.
The implant placed in the stump part of the existing alveolar ridge was believed to help reduce the pressure of the flap on the reconstruction plate.
Implantation of a lower jaw overlay denture that supported the flap on the reconstruction plate and alveolar ridge produced an excellent long-term outcome in this edentulous patient who underwent hemimandibular reconstruction.
