:: Volume 33, Issue 3 And 4 (10-2021) ::
J Iran Dent Assoc 2021, 33(3 And 4): 84-92 Back to browse issues page
Oral Reconstruction of Hemi-Mandibulectomy Patients by Implant Overdenture: Report of Two Cases
Amir Reza Hendi1 , Mehran Falahchai1 , Mahsa Koochaki2 , Donya Maleki * 3
1- Assistant Professor, Dental Sciences Research Center, Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
2- Department of Oral and Maxillofacial Disease, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
3- Student Research Committee, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran , donyamaleki93@gmail.com
Abstract:   (1900 Views)
Introduction: Loss of mandibular continuity, jaw deviation, extensive freely movable soft tissues, and difficulty in mastication, swallowing, and speech are the re-sults of hemi-mandibulectomy, which adversely affect the patients’ quality of life. Management of such patients by fixed or removable prostheses is a complex and chal-lenging approach as the type of prosthesis is a determinant factor in successful reha-bilitation.
Case Presentation: The present report describes prosthetic rehabilitation of two pa-tients who underwent hemi-mandibulectomy due to osteosarcoma. After clinical and paraclinical evaluations and multidisciplinary consultations, it was decided to use implant-supported removable overdenture with stud attachments and an open-structure framework for them.
Results: Jaw reconstruction and dental rehabilitation of hemi-mandibulectomy patients are complicated procedures. However, with regard to developments in dental science, the clinicians have different options to fulfill the esthetic and functional demands of such patients. The current paper showed that implant-supported removable prostheses with stud attachments can successfully re-habilitate the hemi-mandibulectomy defects when the interocclusal space is limited and achieving the implants’ parallelism is a challenge due to the nature of hemi-mandibulectomy procedure.
Keywords: Mandibular Osteotomy, Maxillofacial Prosthesis, Odontogenic Tumors, Rehabilitation
Full-Text [PDF 912 kb]   (589 Downloads)    
Type of Study: Case Report | Subject: Prosthodontics
References
1. Marathe AS, Kshirsagar PS. A systematic approach in rehabilitation of hemimandibulec-tomy: A case report. J Indian Prosthodont Soc. 2016 Apr;16(2):208-12 .
2. Askin SB, Aksu AE, Calis M, Tulunoğlu İ, Safak T, Tözüm TF. Report of multidisciplinary treatment of an extensive mandibular ameloblastoma with free iliac crest bone flap, dental implants, and acellular dermal matrix graft. J Oral Implantol. 2015 Feb;41(1):107-11 .
3. Yoon HI. Prosthetic rehabilitation after fibular free flap surgery of mandibular defects in a patient with oral squamous cell carcinoma. J Craniofacl Surg. 2016 Oct;27(7):e685-8 .
4. Kumar VV, Srinivasan M. Masticatory efficiency of implant‐supported removable partial dental prostheses in patients with free fibula flap reconstructed mandibles: A split‐mouth, observational study. Clin Oral Implants Res. 2018 Aug;29(8):855-63 .
5. Awadalkreem F, Khalifa N, Ahmad AG, Suliman AM, Osman M. Prosthetic rehabilitation of maxillary and mandibular gunshot defects with fixed basal implant-supported prostheses: A 5-year follow-up case report. Int J Surg Case Rep. 2020 Jan 1; 68:27-31 .
6. Kumar VV, Ebenezer S, Kämmerer PW, et al. Implants in free fibula flap supporting dental rehabilitation–Implant and peri-implant related outcomes of a randomized clinical trial. J Craniomaxillofac Surg. 2016 Nov;44(11):1849-58 .
7. Nguyen TT, Eo MY, Myoung H, Kim MJ, Kim SM. Implant-supported fixed and removable pros-theses in the fibular mandible. INT J Implant Dent. 2020 Dec;6(1):1-9 .
8. Kumar VV, Jacob PC, Kekatpure V, Hedne N, Koch FP, Kuriakose MA. The Jugaad technique for jaw reconstruction: denture based inverse planning. J Maxillofac Oral Surg. 2016 Sep; 15 (3):346-8.
9. Goiato MC, Ribeiro AB, Marinho ML. Surgical and prosthetic rehabilitation of patients with hemimandibular defect. J Craniofac Surg. 2009 Nov;20(6):2163-7.
10. Mehra M, Somohano T, Choi M. Mandibular fibu-lar graft reconstruction with CAD/CAM technol-ogy: A clinical report and literature review. J Prosthet Dent. 2016 Jan;115(1):123-8.
11. Stoumpis C, Kohal RJ. To splint or not to splint oral implants in the implant‐supported overden-ture therapy? A systematic literature review. J Oral Rehab. 2011 Nov;38(11):857-69.
12. Rogers SN, Lowe D, Fisher SE, Brown JS, Vaughan ED. Health-related quality of life and clinical function after primary surgery for oral cancer. Bri J Oral Maxillofac Surg. 2002 Feb;40(1):11-8.
13. Goyal P, Manvi S, Arya S. Prosthodontic man-agement of hemimandibulectomy patient: Im-plants, a better solution. J Dent Imp. 2016 Jan;6(1):37-40.
14. Selim K, Ali S, Reda A. Implant supported fixed restorations versus implant supported remova-ble overdentures: a systematic review. Open Access Maced J Med Sci. 2016 Dec;4(4): 726-32.
15. Oh SM, Kim JW, Choi SY, et al. Full-Mouth Reha-bilitation with Bone-Level Implant Guide and Monolithic Zirconia Prosthesis for Fibular Free Flap Reconstruction: A Case History Report. Int J Prosthodont. 2018 Nov;31(6):573-6.
16. Hendi A, koochaki M. Implant-Supported Re-movable Partial Denture In A Mandibular Ken-nedy CL II: A Clinical Report. J Dentomaxillofac Radiol Pathol Surg. 2019 Mar; 8(1):56-9.
17. Al-Harbi FA. Mandibular implant-supported overdentures: Prosthetic overview. Saudi J Med Med Sci. 2018 Jan;6(1):2-7.
18. Srinivasan M, Kalberer N, Maniewicz S, Müller F. Implant overdentures retained by self-aligning stud-type attachments: A clinical report. J Pros Dent. 2020 Jan;123(1):6-14.
19. Maroulakos G, Nagy WW, Ahmed A, Artopoulou II. Prosthetic rehabilitation following lateral resection of the mandible with a long cantilever implant-supported fixed prosthesis: A 3-year clinical report. J Prosthet Dent. 2017 Nov;118(5):678-85.
20. Jacobsen HC, Wahnschaff F, Trenkle T, Sieg P, Hakim SG. Oral rehabilitation with dental implants and quality of life following mandibular reconstruction with free fibular flap. Clin Oral Investig. 2016 Jan;20(1):187-92.
21. Anne-Gaëlle B, Samuel S, Julie B, Renaud L, Pierre B. Dental implant placement after mandibular reconstruction by microvascular free fibula flap: current knowledge and remaining questions. Oral oncol. 2011 Dec; 47 (12):1099-104.
22. Prithviraj, D.R., Madan, V., Harshamayi, P., Ku-mar, C.G. and Vashisht, R., 2014. A comparison of masticatory efficiency in conventional dentures, implant retained or sup-ported overdentures and implant supported fixed prostheses: a literature review. J Dent Imp. 2014 Jul;4(2):153-7.
23. Altintas NY, Kilic S, Altintas SH. Oral Rehabilitation with Implant‐Retained Overdenture in a Patient with Down Syndrome. J Prosthodont. 2019 Feb;28(2):e617-21.
24. Smolka W. Calvarial grafts for alveolar ridge re-construction prior to dental implant placement: an update. Oral Maxillofac Surg. 2014 Dec;18(4):381-5.
25. Bodard AG, Salino S, Desoutter A, Deneuve S. Assessment of functional improvement with implant-supported prosthetic rehabilitation after mandibular reconstruction with a microvascular free fibula flap: a study of 25 patients. J Prosthet Dent 2015 Feb;113(2):140-5.
26. Kim HY, Lee JY, Shin SW, Bryant SR. Attachment systems for mandibular implant overdentures: a systematic review. J Adv Prosthodont 2012 Nov;4(4):197-203.
27. Kleis WK, Kämmerer PW, Hartmann S, Al-Nawas B, Wagner W. A comparison of three different attachment systems for mandibular two-implant over- dentures: one-year report. Clin Implant Dent Relat Res 2010 Sep;12(3): 209-18.
28. Rutkunas V, Mizutani H, Takahashi H, Iwasaki N. Wear simulation effects on overdenture stud attachments. Dent Mater J. 2011 Nov;30(6):845-53.
29. El Mekawy N, Elhawary MY. Clinical evaluation of inter-implant distance influence on the wear characteristics of low-profile stud attachments used in mandibular implant retained overdentures. J Clin Exp Dent. 2019 Jan;11(1): e33-41.

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Volume 33, Issue 3 And 4 (10-2021) Back to browse issues page