Clinical and Radiographic Evaluation of Reconstruction and Prosthetic Rehabilitation of mandibular resection defects using iliac grafts combined with implant placement

Abstract

The aim of the current study was to evaluate efficacy of using iliac grafts combined with implants and retaining a provisional fixed-detachable (hybrid) prosthesis in the reconstruction of mandibular defects regarding average bone loss in graft height, peri-implant marginal bone loss, maximum bite force, facial asymmetry ,patient satisfaction and oral health quality of life (OHRQoL).Patients and methods: 11 patients were subjected to mandibular marginal resection with immediate reconstruction by autogenous iliac crest graft with implant placement. After 6 months they were rehabilitated with provisional screw-retained prosthesis. Radiographic assessment of average bone loss in graft height and marginal bone loss around dental implants was performed. Facial asymmetry, Maximum bite force, Patient satisfaction and oral health quality of life (OHRQoL) were assessed after the first surgery, at loading, 6 and 12 months later.Results: Average bone loss of graft height (mean 2.14±1.03). Average peri-implant Marginal bone loss after 1 year 1.42±0.38. The increase in marginal bone loss along the study period was significant (P<0.001). Maximum bite force of the rehabilitated side increased significantly along the study period. There was a statistically high significant difference between the scores of all OHIP-5 items scores except in the scores of the difficulty doing usual jobs item.Conclusion: Within the limitations of this study, it was concluded that construction of mandibular defect using iliac crest graft combined with dental implants and retaining a provisional fixed- detachable prothesis can be an effective procedure to restore bony defect, facial asymmetry, maximum bite force, patient satisfaction and oral health quality of life.