Functional outcomes with dental prosthesis following simultaneous mandibulectomy and mandibular bone reconstruction

Yumi Mochizuki; Ken Omura; Hiroyuki Harada; Eriko Marukawa; Hiroaki Shimamoto; Hirofumi Tomioka

doi:10.1016/j.jpor.2014.05.001

Functional outcomes with dental prosthesis following simultaneous mandibulectomy and mandibular bone reconstruction

J Prosthodont Res. 2014 Oct;58(4):259-66. doi: 10.1016/j.jpor.2014.05.001. Epub 2014 Sep 18.

Authors

Yumi Mochizuki¹, Ken Omura², Hiroyuki Harada², Eriko Marukawa², Hiroaki Shimamoto², Hirofumi Tomioka²

Affiliations

¹ Departments of Oral and Maxillofacial Surgery and Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan. Electronic address: mochizuki.osur@tmd.ac.jp.
² Departments of Oral and Maxillofacial Surgery and Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.

PMID: 25239102
DOI: 10.1016/j.jpor.2014.05.001

Abstract

Purpose: This study sought to ascertain masticatory outcomes in patients who underwent mandibulectomy or hemimandibulectomy together with mandibular bone reconstruction to allow for placement of a removable dental prosthesis.

Methods: Perioperative changes in masticatory performance, masticatory ability for solids, and patients' subjective satisfaction were evaluated for 101 patients who had mandibulectomy immediately followed by bone reconstruction. Differences in masticatory performance and masticatory ability for solids after surgery were determined according to occlusal support after surgery and whether the patient was wearing a removable dental prosthesis or not. Occlusal support areas were classified according to Eichner's classification.

Results: Preoperative Eichner's class A patients had no experience of wearing a dental prosthesis before surgery and after surgery did not want one. Their masticatory performance was better than that of patients who wanted a dental prosthesis after surgery. Retrospective analysis of postoperative Class B and C patients revealed that masticatory performance was lower in those who wanted a dental prosthesis than in those who did not want one. When patients wore a dental prosthesis after surgery, masticatory performance was markedly improved over not wearing it. All patients' subjective satisfaction was significantly improved after surgery.

Conclusions: Increasing the number of occlusal support areas by wearing a removable dental prosthesis after simultaneous mandibulectomy or hemimandibulectomy and mandibular bone reconstruction may improve masticatory functions. Those professional involved in the rehabilitation for the mandibular defect should be mindful that masticatory functions after such surgeries were affected by the masticatory functions before surgery and the number of occlusal support areas after surgery.

Keywords: Dental prosthesis; Functional outcome; Hemimandibulectomy; Mandibular reconstruction; Segmental mandibulectomy.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Dental Prosthesis / psychology*
Female
Humans
Male
Mandibular Diseases / physiopathology
Mandibular Diseases / psychology*
Mandibular Diseases / rehabilitation*
Mandibular Diseases / surgery
Mandibular Osteotomy*
Mastication / physiology*
Middle Aged
Patient Satisfaction
Perioperative Period
Plastic Surgery Procedures*
Treatment Outcome
Young Adult