Mandibular Prosthesis

Abstract: The functional disability and cosmetic deformity after jaw and neck dissection can be very severe due to soft tissue and mandibular loss. Reconstruction of the mandible alone without soft tissue coverage can be complicated with prosthetic exposure, infection and, finally, rejection. We attempted to reconstruct the mandible at the time of tumor resection in a group of patients, using titanium mesh with marrow, rib, scapular spine, and clavicle. We used myocutaneous flaps in order to obtain intraoral coverage of the mandibular grafts. In a second group of patients, delayed reconstruction of the jaw was performed 6 months to 2 years after tumor resection. Titanium mesh prostheses were used for reconstruction of the mandible in conjunction with myocutaneous flaps for soft tissue augmentation. Osteomyocutaneous flaps were also used. The results and complications in 54 patients are presented.

Abstract: Twenty-seven edentulous patients with denture adaptation problems were first given optimal conventional complete dentures and then a fixed prosthesis on osscointegrated dental implants in the lower jaw (and a complete maxillary denture). Masticatory function was evaluated by means of a questionnaire, a comminution test for chewing efficiency, and bite force measurements on four occasions: with the original (I) and optimal complete dentures (II) and 2 months (III) and 3 years (IV) after insertion of the fixed mandibular prosthesis on implants. No significant improvement of masticatory function was found after conventional denture treatment. After insertion of the fixed mandibular implant bridge, a marked improvement of the patients' assessment of their chewing ability and of the results of the chewing efficiency test and the bite force measurements was recorded. The test results were further improved after the 3-year observation period, which indicates that adaptation to the new prosthetic situation is a g...