RESUMO
The mandibulectomy deformity can be alleviated by immediate mandibular reconstruction using the microvascular fibula free flap. Before the advent of microvascular reconstruction, conventional and maxillofacial prosthetic rehabilitation offered limited success after surgery due to the failure to reestablish the bony foundation and soft tissues (tongue, floor of mouth, vestibule) anatomically and physiologically. With proper multidisciplinary pretreatment planning and postoperative treatment, osseointegrated implants can be strategically placed in patients with these reconstructed mandibles to restore occlusal and masticatory function. The records of seven patients who underwent reconstructive surgery and osseointegrated implants were reviewed, with an emphasis on the variety of prosthetic designs and principles used to maximize long-term efficiency and preservation of tissues.
Assuntos
Transplante Ósseo , Implantes Dentários , Mandíbula/cirurgia , Neoplasias Mandibulares/reabilitação , Retalhos Cirúrgicos , Adolescente , Adulto , Idoso , Feminino , Fíbula/irrigação sanguínea , Fíbula/transplante , Humanos , Masculino , Neoplasias Mandibulares/cirurgia , Pessoa de Meia-IdadeRESUMO
In the past, prosthodontic rehabilitation of patients who underwent segmental mandibular resection relied on removable prostheses, which were less than ideal. The advent of the microvascular free flap has provided improved appearance and function through reconstruction of the skeletal integrity of the mandible. In select patients osseointegrated implants strategically placed in the reconstructed mandible can be used to restore masticatory function. Patient selection criteria and techniques are discussed.