Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap

Summary: Background: Computer-assisted mandibular reconstruction after mandibulectomy enables accurate reconstruction of the occlusal positions between the maxilla and mandible. Understanding the remaining teeth condition is essential for sensory mastication in patients with numerous tooth loss. Ho...

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Main Authors: Koreyuki Kurosawa, Akira Ohkoshi, Ryo Ishii, Naoko Sato, Hitoshi Miyashita, Takayuki Harata, Toshiro Imai, Masanobu Hayashi, Shinyo Ishi, Miki Shoji, Yoshimichi Imai
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JPRAS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352587824001542
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author Koreyuki Kurosawa
Akira Ohkoshi
Ryo Ishii
Naoko Sato
Hitoshi Miyashita
Takayuki Harata
Toshiro Imai
Masanobu Hayashi
Shinyo Ishi
Miki Shoji
Yoshimichi Imai
author_facet Koreyuki Kurosawa
Akira Ohkoshi
Ryo Ishii
Naoko Sato
Hitoshi Miyashita
Takayuki Harata
Toshiro Imai
Masanobu Hayashi
Shinyo Ishi
Miki Shoji
Yoshimichi Imai
author_sort Koreyuki Kurosawa
collection DOAJ
description Summary: Background: Computer-assisted mandibular reconstruction after mandibulectomy enables accurate reconstruction of the occlusal positions between the maxilla and mandible. Understanding the remaining teeth condition is essential for sensory mastication in patients with numerous tooth loss. However, no studies have examined the dental status of the remaining mandible after computer-assisted mandibular reconstruction using a fibular flap. This study evaluated the role of residual teeth and other factors in effective acquisition of oral intake after computer-assisted mandibular reconstruction using a fibular flap. Patients and Methods: Postoperative oral intake and associated factors were retrospectively examined in 57 consecutive patients. Oral intake was assessed using the Functional Oral Intake Scale. Multivariate analysis was performed to evaluate the remaining teeth arrangement (Eichner's classification), mandibular dentures, extent of resection (Brown's classification), age, performance of glossectomy, history of radiation therapy, and computer-assisted methods. Results: Multivariate analysis revealed that Eichner's classification had a positive (p<0.001) and radiation therapy had a negative (p<0.05) impact on oral intake. The patients with dentures anchored to the remaining teeth in the occlusal support area (i.e., premolar and molar) had higher Functional Oral Intake score than those with dentures anchored to the remaining teeth in the non-occlusal support area (6.78±0.03 vs. 6.10±0.07, p<0.005). Conclusion: In computer-assisted mandibular reconstruction with accurate occlusion, the residual teeth in the occlusal support area are essential for good postoperative oral intake with dentures. During mandibulectomy, if oncologically acceptable, these teeth should be preserved, and selective placement of dental implants in the occlusal support area should be considered.
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spelling doaj-art-bb3aaecd73de45b38d0e54896c40c4242025-08-20T02:37:33ZengElsevierJPRAS Open2352-58782024-12-014235036010.1016/j.jpra.2024.10.002Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flapKoreyuki Kurosawa0Akira Ohkoshi1Ryo Ishii2Naoko Sato3Hitoshi Miyashita4Takayuki Harata5Toshiro Imai6Masanobu Hayashi7Shinyo Ishi8Miki Shoji9Yoshimichi Imai10Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, Japan; Corresponding author. Koreyuki Kurosawa M.D, PhD, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, Japan. Tel: +81-22-717-7332; Fax: +81-22-717-7335.Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanMaxillofacial Prosthetics Clinic, Tohoku University Hospital, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Dentistry and Oral Surgery, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai 983-8512, JapanDental Laboratories, Central Clinical Facilities, Tohoku University Hospital, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanSummary: Background: Computer-assisted mandibular reconstruction after mandibulectomy enables accurate reconstruction of the occlusal positions between the maxilla and mandible. Understanding the remaining teeth condition is essential for sensory mastication in patients with numerous tooth loss. However, no studies have examined the dental status of the remaining mandible after computer-assisted mandibular reconstruction using a fibular flap. This study evaluated the role of residual teeth and other factors in effective acquisition of oral intake after computer-assisted mandibular reconstruction using a fibular flap. Patients and Methods: Postoperative oral intake and associated factors were retrospectively examined in 57 consecutive patients. Oral intake was assessed using the Functional Oral Intake Scale. Multivariate analysis was performed to evaluate the remaining teeth arrangement (Eichner's classification), mandibular dentures, extent of resection (Brown's classification), age, performance of glossectomy, history of radiation therapy, and computer-assisted methods. Results: Multivariate analysis revealed that Eichner's classification had a positive (p<0.001) and radiation therapy had a negative (p<0.05) impact on oral intake. The patients with dentures anchored to the remaining teeth in the occlusal support area (i.e., premolar and molar) had higher Functional Oral Intake score than those with dentures anchored to the remaining teeth in the non-occlusal support area (6.78±0.03 vs. 6.10±0.07, p<0.005). Conclusion: In computer-assisted mandibular reconstruction with accurate occlusion, the residual teeth in the occlusal support area are essential for good postoperative oral intake with dentures. During mandibulectomy, if oncologically acceptable, these teeth should be preserved, and selective placement of dental implants in the occlusal support area should be considered.http://www.sciencedirect.com/science/article/pii/S2352587824001542Mandibular reconstructionFibular flapOral intakeDentureTeethVirtual surgical planning
spellingShingle Koreyuki Kurosawa
Akira Ohkoshi
Ryo Ishii
Naoko Sato
Hitoshi Miyashita
Takayuki Harata
Toshiro Imai
Masanobu Hayashi
Shinyo Ishi
Miki Shoji
Yoshimichi Imai
Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap
JPRAS Open
Mandibular reconstruction
Fibular flap
Oral intake
Denture
Teeth
Virtual surgical planning
title Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap
title_full Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap
title_fullStr Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap
title_full_unstemmed Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap
title_short Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap
title_sort role of residual mandibular teeth after computer assisted mandibular reconstruction using a fibular flap
topic Mandibular reconstruction
Fibular flap
Oral intake
Denture
Teeth
Virtual surgical planning
url http://www.sciencedirect.com/science/article/pii/S2352587824001542
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