Takayuki Kosaka1, Masahiro Wada1*, Suzuna Akema1, Kazuhide Matsunaga2, Narikazu Uzawa2 and Kazunori Ikebe1
1Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Japan
2Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Japan
Background: The extensive loss of teeth and surrounding tissues due to mandibulectomy for an oral tumor not only impacts negatively on appearance, but also often causes various functional disorders, decreasing Quality of Life (QOL). In the present case, reconstruction with a scapular flap was carried out along with segmental mandibulectomy, aiming for functional restoration through restoration-driven implant treatment. A good outcome was obtained, with improvement of masticatory function and QOL following the prosthetic treatment. Case Report: The patient was a 37-year-old woman diagnosed with ossifying fibroma in the left side of the mandible. Segmental mandibulectomy and reconstruction with a scapular flap were carried out. Implant diagnostic simulation was performed, and based on the result secondary reconstruction using a particulate cancellous bone and marrow graft was carried out by an oral surgeon. After wound healing was complete, implant surgery was performed twice, and the final prosthetic treatment was completed. Masticatory performance and maximum bite force, which are indices of masticatory function, were improved from before to after prosthetic treatment. In addition, oral health-related QOL was improved from before to after prosthetic treatment. Conclusion: In the present case, restoration-driven implant treatment was performed in a patient following segmental mandibulectomy for a mandibular tumor, with a good outcome. Planning the treatment measures with a focus on the final prosthetic vision can lead to improvement of oral function in patients with extensive mandibular defects.
Mandibulectomy; Scapular flap; Implant; Mastication; Quality of life
Kosaka T, Wada M, Akema S, Matsunaga K, Uzawa N, Ikebe K. Restoration-Driven Implant Treatment after Mandibular Resection with a Scapular Flap: A Case Report. Ann Clin Case Rep. 2021; 6: 2034..