Bite Force Evaluation in Implant-Assisted Prosthetic Rehabilitation of Reconstructed Jaws Utilizing Vascularized Free Fibula Flap: A Retro-Prospective Cohort Study.

Abstract

Maxillary and mandibular defects due to tumor ablation pose considerable challenges to the reconstructive surgeon and in prosthetic management. Dental implants placed in vascularized fibula free flaps are considered to be a dependable technique for prosthetic rehabilitation in head and neck cancer patients. Although, there is evidence of survival of dental implants in the reconstructed jaw bones, there is lack of information regarding the masticatory performance and prosthetic success. The maximum bite force achieved through the prosthetic appliance is a measure of the therapeutic outcome. The purpose of this study was to determine the maximum bite force achieved through implant-assisted prosthetic rehabilitation in reconstructed jaw bones utilizing vascularized free fibula flap. The study included a total of 65 implants, from 16 patients who underwent surgical resection of jaw bones due to benign tumors followed by rehabilitation with implant-assisted fixed or removable prosthesis. The maximum bite force was determined with a transducer. Occlusal interferences were analyzed with mounted casts. The parameters were reviewed every 3months have T 0 marked the baseline assessment, and T 3, T 6, T 9, T 12, and T 15 were subsequent review periods. The mean occlusal force was increased in most of the patients through 15months (P < 0.01). The maximum bite force measured in the reconstructed mandible and maxilla were 225.63N and 176.51N, respectively. Occlusal interferences were absent in 68.8% of the study population. The bite force measured in reconstructed maxilla and mandible is comparable to the masticatory force measured with conventional implant supported prosthesis in native mandible and maxilla.