Factors Affecting Dental Rehabilitation Following Jaw Reconstruction With Free-Fibular Graft In Patients With Head and Neck Cancer. Issue 8 (November 2018)

• Record Type: Journal Article
• Authors: Dholam, Kanchan P.; Singh, Gurkaran Preet; Gurav, Sandeep V.; Yadav, Prabha
• Is Part Of: Journal of craniofacial surgery. Volume 29:Issue 8(2018)
• Publication Date: 2018-11
• Subjects: Dental implant -- free-fibular graft -- head and neck cancer -- maxillomandibular -- oral rehabilitation -- radiotherapy -- relationship; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000004824
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Abstract: Existing anatomic factors play a significant role in affecting the possibility of dental rehabilitation in head and neck cancer patients undergoing free-fibular graft reconstruction. An observational, cross-sectional study was initiated to evaluate factors affecting dental rehabilitation following free-fibular graft jaw reconstruction in head and neck cancer patients. Patients who had undergone jaw reconstruction with free-fibular graft, requiring dental rehabilitation were recruited. Irradiated, reconstructed patients who had completed at least 1 year since the last dose of radiotherapy and nonradiated patients who had completed 6 months since reconstruction were recruited. Patients who had undergone soft-tissue reconstruction or free-fibular graft in non-condyle sparing resections were excluded. Patient's demographic data, disease and treatment-related data were obtained. An intra-oral examination was carried out to evaluate anatomic variables affecting dental rehabilitation. Descriptive statistical analyses were carried out to study demographic data. Logistic regression analysis was carried out using Pearson χ 2 test and Fisher exact test. Estimates of regression coefficient and their standard errors with 95% confidence interval were calculated. Total of 138 patients were enrolled and considered for prosthetic rehabilitation. A review of the frequency-based data revealed that 30% (n = 41) patients were considered suitable for prosthetic rehabilitation. On multivariate logistic regression analysis, morbidity of radiotherapy ( P = 0.01), interference to placement of implants by reconstruction plates and screws ( P = 0.023), unfavorable diagnostic maxilla-mandibular relationship ( P = 0.011), and obliterated vestibule ( P = 0.001) were statistically established ( P < 0.05) as the most significant reasons for not carrying out dental rehabilitation in patients who had undergone free-fibular graft reconstruction. Abstract : Supplemental Digital Content is available in the text