Abstract
ObjectiveReconstruction plates are used to treat patients with a segmental mandibular defect after oral cancer surgery. Reconstruction plate failure analysis has rarely focused on occlusion, which conducts a mechanical force to the mandible and the plate. To determine the prognostic factors, we retrospectively evaluated patients who underwent reconstruction of a mandibular segmental defect with a reconstruction plate and assessed the number of residual paired teeth.Material and MethodsFrom among 390 patients with oral cancer who visited University of Tsukuba Hospital (Tsukuba, Japan) between 2007 and 2017, we selected and analyzed the data of 37 patients who underwent segmental resection of the mandible and reconstruction with reconstruction plates. Prognostic factors evaluated were patient age, sex, TNM classification, plate manufacturer, treatment with radiotherapy or chemotherapy, whether the patient had diabetes or smoked, and whether the patient had a small number of residual paired teeth, plate length, and use of a fibular‐free flap. Among these 37 patients, eight reconstruction plates had intraoral or extraoral exposure and were removed in 5 years.ResultsKaplan–Meier and log‐rank analyses revealed that the prognosis for the 5‐year plate exposure‐free rate was significantly poorer for patients with a small number of residual teeth than for patients with no teeth or those with a large number of residual teeth (.01). Univariate Cox regression analysis revealed that a small number of residual teeth was a significant prognostic factor in the loss of a reconstruction plate (hazard ratio: 5.63; 95% confidence interval [1.10, 25.85]; .04).ConclusionsA small number of residual teeth after the segmental resection of oral cancer is significantly involved in reconstruction plate survival and may be important in predicting reconstruction plate prognosis.
Highlights
We investigated the predictive factors of reconstruction plate exposure by using the number of paired teeth as a variable to define prognostic factors for reconstruction plate loss and to improve future treatment planning
The univariate analysis of each factor revealed a significant difference between the small number of teeth group and the other group
We retrospectively investigated the prognostic factors for the loss of reconstruction plates in patients with a mandibular segmental defect
Summary
Treating advanced oromandibular cancer often requires resecting mandibular and alveolar bones and soft tissues such as the oral mucosa, muscles, or external skin of the mandible. Prognostic factors determined from the patients' medical records were as follows: the patients' age and sex; stage of the cancer; number of screws; number of residual paired teeth; plate manufacturer (MODUS 2.5‐mm locking reconstruction plate [Mediartis, Basel, Switzerland]; Lorenz 2.4‐mm locking reconstruction plate [Biomet, Jacksonville, USA]; CMF 2.4‐mm titanium locking reconstruction plate [Synthes GmbH, Oberdorf Switzerland]); type of flap (i.e., no flap, fibular‐free flap, rectus abdominis myocutaneous flap, nasolabial flap, or latissimus dorsi flap); infection site; stage; whether the patient had diabetes or smoked; and whether the patient had received chemotherapy or radiotherapy. Male Female Plate length (mm) Number of screws Number of residual paired teeth Manufacturer Mediartis MODUS 2.5‐mm locking reconstruction plate Biomet Lorenz 2.4‐mm locking reconstruction plate Synthes CMF 2.4‐mm Titanium locking reconstruction plate Flap No flap Fibular‐free flap Rectus abdominis myocutaneous flap Nasolabial flap Latissimus dorsi flap Site infection Yes No TNM classification stage 1 2 3 4a 4b Diabetes mellitus Yes No Smoking Yes No Chemotherapy Yes No Radiation therapy Yes No
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
