Dental Rehabilitation Research Articles

Exploring the comprehensive review of diagnostic methods of oral cancer: A global scenario

Oral cancer is one of the common cancers in the worldwide, with a delayed clinical detection and prognosis. There is no specific biomarkers for this kind of disease and also no expensive therapeutic alternative methods. It is two to three times more prevalent in men than women in most ethnic groups. It is a preventable disease, where smoking and alcohol-considered major risk factors. India has one of the highest incidences of oral cancer and delayed stage recovery is common. Surgery remains the treatment of choice and adjuvant treatment is recommended in patients with high-risk. Functional outcomes and treatment-related morbidity needs to be considered, and reconstruction with free tissue transfer provides the best outcomes. Particularly while speech, swallowing, mastication efficiency, and dental rehabilitation. Future generations has to fight these dreadful diseases until scientists and clinicians are provided the opportunities to expand efforts to prevent, detect (early), and eradicate oral and other head and neck cancers.

Factors Affecting Complete Oral Rehabilitation in Patients With Vascularized Free Fibula Flap Mandibular Reconstruction: A 10-Year Retrospective Study.

The fibula is the preferred bone flap for mandibular reconstructions due to its many advantages, including the possibility to insert dental implants. All patients who received a mandibular reconstruction with a vascularized free fibula flap at the Uppsala University Hospital between 2009 and 2019 were retrospectively examined regarding the proportion of implant insertion and factors that affected implant outcome. Forty-one patients had 42 fibula flap reconstructions. Eleven patients (27%) received dental implants and 8 (20%) completed dental rehabilitation. Patient death and cancer recurrence were the main reasons for not receiving implants. The survival rates of implants placed in irradiated and nonirradiated fibulas were 15% and 76%, respectively. Less than 20% of reconstructed patients received an implant-supported prosthesis. Implants placed in an irradiated fibula should be considered at high risk for implant loss.

Are parents of high caries risk Dutch children motivated to brush their children's teeth? An assessment using the health action process approach questionnaire.

To assess the social cognitive constructs of the Health Action Process Approach (HAPA) of parents of high caries risk children to be treated under intravenous sedation (IVS) or with behavioural guidance techniques (BGT), and to assess the changes in these constructs for each treatment group after treatment. In this cohort study, 160 children aged 3-10years were allocated by their paediatric dentist to either IVS (77.4%) or BGT. Their parents filled out a HAPA questionnaire, before (T1, n = 160), immediately (T2, n = 108) and three months (T3, n = 71) after their children's dental rehabilitation. Before treatment, all parents had high scores on all social cognitive constructs. There were no differences in mean HAPA scores between the treatment groups (p > 0.05). After treatment, mean scores changed in both groups. In the BGT group, action self-efficacy changed from 3.64 (T1) to 3.36(T2) (p = 0.027) and to 3.13 (T3) (p = 0.021) and coping self-efficacy changed from 3.63 (T1) to 3.23 (T2) (p = 0.015). In the IVS group, action planning changed from 3.25 (T1) to 3.05(T3) (p = 0.036) and action control changed from 2.58 (T1) to 2.82 (T2) (p = 0.012) and to 2.87 (T3) (p = 0.006). High scores on social cognitive constructs of parents of children referred to a paediatric dentist showed that they seem to be motivated to brush their children's teeth, irrespective of the treatment group. Small changes were observed in the HAPA constructs, however, these are not considered clinically relevant.

Evaluation of oral health-related quality of life following dental rehabilitation under general anesthesia in Turkish children with early childhood caries.

Early childhood caries (ECC) is one of the most common dental problems, which often require dental rehabilitation with general anesthesia (DRGA). To assess the short- and long-term effects of DRGA on children and their families' oral health-related quality of life (OHRQoL) in preschool children, the incidence of complications on the first day, and the factors affecting them and parental satisfaction. A total of 150 children treated for ECC under DRGA were included in the study. OHRQoL was assessed on the day of DRGA, 4 weeks, and 1 year after treatment using the Early Childhood Oral Health Impact Scale (ECOHIS). The incidence of complications and parental satisfaction with DRGA were evaluated. The data were analyzed for statistical significance (p < .05). In total, 134 patients were re-evaluated at the end of the fourth week and 120 at the end of the first year. The average ECOHIS scores before and after DRGA (4 weeks and 1 year) were 18.1 ± 8.5, 3.1 ± 3.9, and 5.9 ± 6.2, respectively. After DRGA, 29.2% of the children reported at least one complication. Ninety-one percent of the parents reported that they were satisfied with DRGA. DRGA has a positive effect on the OHRQoL of Turkish preschool children with ECC and is highly evaluated by their parents.

Assessment Of Gingival Phenotype At The Aesthetic Zone In A Malay Population Using Probe Test

Introduction: The gingival phenotype (GP) of teeth at the aesthetic zone often influences dental rehabilitation plans and treatment outcomes. This study aimed to assess the prevalence of GP in the Malay population in relation to gender and age. Methods: The GP of 100 patients were determined using the Probe test method. Other clinical parameters were assessed include crown width/crown length (CW/CL) ratio, tooth morphology and width of keratinised tissue. Periodontal parameters were assessed by two calibrated examiners. Data were analysed using descriptive statistics, one-way ANOVA and Kruskal-Wallis test. Results: A higher prevalence of thick GP was found at the maxilla for both genders, whereas a thin phenotype was observed at the mandible. At maxilla, both thick and thin GP were found in all age groups, while the mandible showed a higher prevalence of thin GP. Significant differences in GP were found between males and females for mandibular and maxillary anterior teeth and the mandibular lateral incisor (p&lt;0.05), while no significant difference was found for other parameters assessed; age group, CW/CL, tooth morphology and WKT. Conclusion: Thicker GP is more prevalent in male population and at maxillary anterior. Mandibular anterior GP presented commonly with a thin GP regardless of gender or age-group.

A Comparison of Surgeon Estimated Times and Actual Operative Times in Pediatric Dental Rehabilitation under General Anesthesia. A Retrospective Study.

This retrospective study aimed to compare the accuracy of the pediatric dental surgeon's estimated operative times for dental rehabilitation under general anesthesia (DRGA) in pediatric patients. This study population included 674 pediatric patients who underwent DRGA at the study facility between January 2022 and December 2022, using convenience sampling to select patients who met our inclusion criteria. Data were collected from electronic medical and anesthesia records based on several factors, including patient-related factors such as age and gender, surgeon-related factors such as rank and experience, and anesthesia-related factors such as induction and recovery time (in minutes). This study highlights a significant difference between the surgeon's estimated time (SET) and actual operative time (AOT) for pediatric DRGA procedures, with a mean difference of 19.28 min (SD = 43.17, p < 0.0001), indicating a tendency for surgeons to overestimate surgery time. Surgical procedure time was the strongest predictor of this discrepancy, with an R square value of 0.427 and a significant p-value of 0.000. Experience with surgeons, anesthesia induction, and recovery time were also significant predictors. Meanwhile, age, gender, and rank of surgeons did not significantly predict the difference between SET and AOT. Therefore, the study suggests that surgeons should adjust their estimates for pediatric DRGA procedures, specifically emphasizing a more accurate estimation of surgery time, to ensure adequate resource allocation and patient outcomes.

Comparison of Total Salivary Antioxidant Capacity of Children with and without Severe Early Childhood Caries before and after Complete Dental Rehabilitation.

Early childhood caries (ECC) is the most chronic disease affecting children all over the world. Children often complain of pain and need complete rehabilitation, which is often done under general anesthesia due to extensive treatment and behavioral problems that are often encountered. The present study was undertaken to evaluate the total salivary antioxidant capacity of children with severe ECC (S-ECC) before and after complete dental rehabilitation and compare it with caries-free children. Salivary samples were obtained from 30 children aged 3-5 years and diagnosed with S-ECC, along with 30 age and sex-matched controls. Complete dental rehabilitation under general anesthesia was performed on the children with S-ECC, and follow-up salivary samples were obtained after 3 and 6 months postoperatively. Total salivary antioxidant capacity was measured using a commercially available Oxygen Radical Absorbance Antioxidant Assay measurement kit. At baseline, children with S-ECC had higher total antioxidant capacity (TAC) compared to the controls. A significant difference in total salivary antioxidant capacity between both groups was seen at baseline. At 3 months following, the total salivary antioxidant capacity of children treated for S-ECC was slightly higher than controls but had significantly reduced compared to baseline. At 6 months, there was no significant difference between both groups. Within the limitations of our study, it can be concluded that the total salivary antioxidant capacity associated with children suffering from S-ECC is reduced after complete rehabilitation. Mathew MG, Jeevanandan G. Comparison of Total Salivary Antioxidant Capacity of Children with and without Severe Early Childhood Caries before and after Complete Dental Rehabilitation. Int J Clin Pediatr Dent 2023;16(3):474-477.

Oral Health Screening for Risk Reduction for Early Periprosthetic Joint Infections of Hip and Knee Endoprostheses—Results of a Prospective Cohort Study

This prospective observational study had two aims: (I) to assess whether a preoperative dental screening before endoprosthesis (EP) implantation with need-based dental intervention would decrease the prevalence of periprosthetic joint infection (PJI) and (II) to evaluate whether instructed orthopedic surgeons would achieve similar results in oral screening as dentists. The preoperative oral health statuses of the patients, prior to EP insertion, were either evaluated by the patients’ general dentists (Ia) or, if the patient had not visited a general dentist, by an instructed orthopedic surgeon (Ib). Both the dentist and orthopedic surgeon used standardized risk estimation (low risk, moderate risk, and high risk) for an oral-health-related infectious complication after EP insertion, including a recommendation for further management of the patient. If required, a need-based dental rehabilitation was performed. In addition, retrospective data evaluation of a comparison group (II) was performed, which had not been screened orally preoperatively. A total of 777 patients (screening group (I): n = 402, of which 229 were screened by a dentist (Ia), 173 were screened by an orthopedic surgeon (Ib); comparison group (II): n = 375) were included. No general association between early infection rate and preoperative oral screening in general was found (1% PJI in screening group (I), 1.6% PJI in comparison group (II); p = 0.455). However, screening performance (dentist vs. orthopedic surgeon) had a significant impact on the prevalence of developed PJIs (p = 0.021). Thereby, 100% of observed infections in the screening group (I) occurred in the group with previous oral screening by an orthopedic surgeon (Ib). Furthermore, the C-reactive protein (CRP) value at discharge was significantly lower when general preoperative oral screening had been performed (group I vs. group II, p = 0.03). Only preoperative oral screening by a dentist had the potential to reduce oral-focus-associated EP infections; therefore, increased attention should be paid to the further promotion of interdisciplinary work between dentists and orthopedic surgeons. Dental screenings, using objectifiable criteria, as applied in this study, seem reasonable but require further validation in larger cohorts.

Comparative assessment of physical and mechanical indicators of packing materials of complete removable dentures

Successful dental rehabilitation of a patient with complete removable dentures depends not only on a number of features of the selected design and clinical conditions of the patient's prosthetic area. Also on the manufacturing technology of the materials used for its manufacture. The purpose of our study was a comparative assessment of the physical and mechanical properties of doped packing materials for removable denture structures using an improved method. An alloyed packing material based on gypsum and supergypsum, modified with nitrile rubber latexes and organosilicon emulsion, was developed. The selected modifiers differ in their structure, group polarity and lyophilicity. The comparative analysis of the quality of auxiliary dental materials included a generalization of the results of a laboratory study of the physical and mechanical properties of various types of plaster. In the system of qualitative assessment of plasters, the indicative properties of auxiliary materials were investigated: "ORTHOGYPS", "Gypsum highness type 10", "Base Stone", provided by ISO 6873, which are divided by us into technological (defining features of the material packaging process) and physical and mechanical (total working time, structuring time, relative expansion during structuring, relative expansion after structuring, compressive strength, linear shrinkage). As a result, it was determined that the developed modified components of the alloy packing material, in turn, provided acceptable accuracy of the base of the removable dentures, which corresponded to the working model due to the improvement of the physical and mechanical properties of the packing material and, as a result, improved manufacturability of removable orthopedic structures of dental prostheses. Keywords: orthopedic treatment, physical and mechanical properties, complete removable dentures, modifier, gypsum mixture.

Phenotypic signs of connective tissue dysplasia in adolescents

Introduction. Connective tissue dysplasia (СTD) is a group of polymorphic pathological conditions caused by hereditary or congenital defects in collagen synthesis and accompanied by a violation of the functions of the musculoskeletal system and internal organs, which is considered as a factor in the development of pathology of the maxillofacial region in children: dystrophic forms of periodontal diseases; anomalies of shape, size, teething; pathology of the temporomandibularthe mandibular joint. There are diffi culties in determining the pathogenetic relationship between CTD and individual nosological forms of dental diseases, which is important for determining the prognosis of their course and the choice of methods of rehabilitation of children. It is important to improve the methodology of preventive examinations in relation to the early detection of phenotypic signs of CTD, including in the maxillofacial region. Substantiation of the connection of CTD with dental diseases will make it possible to develop examination and medical examination schemes, increase the effectiveness of comprehensive prevention of dental diseases and rehabilitation of adolescents with combined pathology.The aim is to study the incidence of CTD in adolescents and its relationship with dental diseases in order to develop a scheme of examinations and medical examinations, increase the effectiveness of comprehensive prevention of dental diseases and rehabilitation of adolescents with combined pathology.Materials and methods. A survey of 140 male adolescents aged 15–18 years, students of schools in Smolensk was conducted. When examining the somatic status, generally accepted markers of CTD were taken into account: bone (asthenic type of constitution, scoliotic deformity of the spine, hallux valgus, chest deformities), skin (increased skin extensibility of more than 3 cm), articular (hypermobility of joints) and visceral (changes from the cardiovascular system — prolapses of the heart valves, abnormally located chords; changes from the respiratory organs — polycystic lung disease, trachiobronchial dyskinesia; changes from the urinary system — nephroptosis, kidney doubling; changes from the gastrointestinal tract — visceroptosis, gallbladder anomaly; changes from the blood system — thrombocytopathy, hemoglobinopathy). When examining the dental status, the following generally accepted markers of CTD were taken into account: malocclusion (prognathia, deep bite, their combination), narrowing of the dentition, anomalies of the position of individual teeth, anomalies of soft tissue attachment, gum recession, chronic gingivitis. The diagnosis of CTD and the health group was established by a pediatrician on the basis of clinical recommendations and the order of the Ministry of Health of the Russian Federation № 621 dated 30.12.2003 «On a comprehensive assessment of the health status of children». Factor analysis was used to form a set of signs combining signs of CTD and dental diseases.Results. Of the phenotypic signs of СTD, bone and joint changes were diagnosed in 79,3 % (95 % CI 72,6– 86) of adolescents. In second place in frequency 35 % (95 % CI 27,1–42,9) were signs of СTD of the cardiovascular system and the organ of vision (myopia). 40 % (95 % CI 31,9–48,1) of the examined adolescents were diagnosed with chronic gingivitis, gum recession. Deep bite and prognathia were more common than other malocclusions: in 40,7 % (95 % CI 32,6–48,9) and 17,1 % (95 % CI 10,9–23,4), respectively. The use of factor analysis allowed us to identify four most informative factors (the fi rst of them is the most signifi cant) to characterize the relationship between the signs of CTD and its dental manifestations.Conclusion. The incidence of CTD in males in the age group of 15–18 years is 43 %. The most informative prognostic factor was the relationship of tracheobronchial dyskinesia with prognathia, deep bite, narrowing of the jaws, generalized gingivitis. The interrelation of signs of СTD of the cardiovascular system and bone-joint changes with gum recession, chronic gingivitis, prognathia and deep bite was also revealed.

Evaluation of Clinical and Oral Findings in Patients with Epidermolysis bullosa.

Introduction: Epidermolysis bullosa (EB) is a genetically inherited disease characterized by recurrent bullae and erosions on the skin with numerous signs of dental caries and poor oral hygiene. The aim of this study was to investigate the general clinical and oral findings of patients with EB. Materials and Methods: In this prospective study, the clinical and oral findings and family history of 26 cases with EB were evaluated. The type of EB, gender, age, parental consanguinity, dental caries, oral findings, distribution of lesions and presence of associated anomalies, clinical and oral findings correlated with gender were recorded. Results: All 26 patients with EB had a history of consanguinity and siblings with EB to varying degrees. In our study, malnutrition, anemia and growth retardation, gastrointestinal system complications, hair thinning, hand and nail deformity, ocular problems and renal disease (in one case) were observed with variable frequencies. When the intraoral findings of the patients were investigated, extensive dental caries in all EB types, enamel hypoplasia in junctional EB (JEB) and the presence of tooth-root to be extracted in dystrophic EB (DEB), intraoral bullae and lesions, ankyloglossia, vestibular sulcus insufficiency, microstomia and maxillary atrophy were observed. Three cases had restorative treatment and one case had prosthetic rehabilitation. Conclusions: Oral involvement can be seen with varying frequencies depending on the type of EB and the severity of the disease. It may result from delayed oral and dental rehabilitation due to physical disabilities, limitations and more pressing medical problems. Microstomy, pain from mucosal lesions, and restricted access to the mouth can be caused by poor oral hygiene. Oral complications and caloric needs of individuals with EB should be determined, and individual prophylaxis should be applied to prevent caries formation and protect teeth.

Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries.

To evaluate the change in quality of life, dental fear, and dental anxiety in young children following full-mouth dental rehabilitation under general anesthesia for early childhood caries. About 200 children who were diagnosed with early childhood caries requiring full-mouth rehabilitation under general anesthesia were recruited after obtaining parental consent. Oral health-related quality of life (OHRQoL) was measured using the Early Childhood Oral Health Impact Scale (ECOHIS). Dental fear was evaluated using Children's Fear Survey Schedule-Dental Subscale and dental anxiety was evaluated using the Facial Image Scale. Scores were taken on the day of intervention, and after 14 days when the child reported for posttreatment follow-up. All 200 participants returned for a follow-up visit after 2 weeks. The child impact section was reduced from 15.7 ± 4.1 to 7.7 ± 1.9 after treatment. The family impact section was reduced from 9.6 ± 2.7 to 3.5 ± 2.6 after treatment. A statistically significant difference was seen in both sections when pre-and posttreatment values were compared (p < 0.001). The total ECOHIS showed statistically significant improvement as the pretreatment score of 21.6 ± 9.5 reduced to 11.2 ± 4.2 showing 51.9% improvement in OHRQoL after full-mouth rehabilitation under general anesthesia was done (p < 0.001). Dental fear and anxiety among the participants showed a statistically significant reduction after treatment was done and most participants were found to be less fearful of doctors, dentists, and injections after treatment. Full-mouth rehabilitation was found to be a reliable treatment modality to improve the OHRQoL of children suffering from early childhood caries. Significant improvement was seen in the OHRQoL within 2 weeks after treatment and most participants were found to be less anxious and fearful toward dentists and dental treatment. Comprehensive dental rehabilitation under general anesthesia has been proven to be an effective treatment modality for early childhood caries and a productive treatment technique to reduce dental fear and anxiety.

Proprioception and osseoperception in prosthodontics – A review

The masticatory system receives neural inputs by means of proprioception and perception. Defective proprioceptive or perceptive input results in dysfunctional or pathological conditions. The prognosis of a prosthodontic restoration depends on the integration of proprioceptive input and motor output. The absence of intradental and periodontal mechanoreception accompanying tooth loss alters the fine proprioceptive control feedback. Complete denture rehabilitation is a compromised restoration which restores function with many lacunae. In contrast to conventional dentures, implant-supported prostheses restore jaw function with improved psychophysiological discriminatory ability, oral stereognosis, and osseoperception.

Does dental rehabilitation under general anaesthetic contribute to the development of temporomandibular disorders in children and adolescents? A scoping review.

Temporomandibular disorders (TMDs) have multiple aetiological factors. Although some evidence suggests invasive and lengthy dental procedures may contribute towards TMD development, there is a relative paucity in the literature regarding an association between elements of paediatric dental general anaesthesia (pDGA) and TMDs. This review aims to consider the impact of dental rehabilitation (and its constituent elements) performed under general anaesthesia on the development of TMDs in childhood and adolescence and identify theories and/or gaps in knowledge which may benefit from future research. Due to the need to preliminarily examine the nature and extent of the current evidence base, a scoping review approach was chosen. The review was conducted based on the framework provided by the methodological working group of the Joanna Briggs Institute (JBI) for conducting systematic scoping reviews. Electronic databases MEDLINE, Embase, Scopus, Web of Science and Cochrane Library were searched as well as the grey literature using OpenGrey, Nexis, Ethos, Google Scholar and ProQuest, with eligible studies uploaded onto Zotero (Mac Version 5.0.96.2). A total of 810 records were identified. After removing duplicates and those not available in English, 260 were identified for title and abstract screening. Seventy-six records underwent full-text review of which only one met the broad inclusion criteria. The most common reasons for exclusion were no specific relation to general anaesthesia, not specifically relating to dental treatment and only being concerned with TMD management. The included study found that while development of TMDs following dental rehabilitation under GA did occur in children, whether the problems caused by treatment were exacerbated by other elements of the pDGA process remains unknown. This review has confirmed a distinct paucity of research in this field. While there is no current tangible scientific evidence that common and routine dental procedures lead to TMD, the literature shows that alterations to any one or a combination of critical factors can contribute to TMD development, which may be collectively exacerbated by iatrogenic macrotrauma during the pDGA process. We have highlighted elements of pre-, peri- and post-operative pDGA, alongside biopsychosocial factors, which may contribute to TMD development in childhood and adolescence and may benefit from future research.

A staged approach to oromandibular reconstruction using the iliac crest free flap in the setting of bilateral failed fibula free flaps.

While a single-stage free-flap reconstruction is the preferred approach for oromandibular defects, a multistaged approach may be necessary in rare cases. These patients can still be effectively restored with functional and aesthetic improvements. We report two cases with a history of bilateral failed fibula free flaps. We detail the multistaged reconstruction to repair these complex defects and discuss the considerations when planning such procedures. Both patients successfully underwent a staged reconstruction with an iliac crest osteocutaneous flap following either a rectus abdominis or pectoralis major myocutaneous flap. Oromandibular reconstruction is an expected outcome in the contemporary management of oral cavity cancer and osteoradionecrosis. However, complications do occur and can be devastating. In cases of bilateral failed fibula free flaps, a staged approach is a favorable option. Moreover, the iliac crest provides an important reconstructive option with the documented potential for implant born dental rehabilitation.

Simplified Zygomatic Implant Perforated (Zip) Flap for Rehabilitation in Low Level Maxillary Defects

Rehabilitation in Low level maxillectomy cases has plethora of options right from local flaps to microvascular flaps. Subsequent to flap surgery, a maxillary dental rehabilitation can be demanding and a fixed or removable prosthesis is obligatory to provide them with near-normal function and aesthetics. Unlike the original ZIP flaps which were dedicated to microvascular flaps, we present here our unique experience with ZIP-Temporalis flap specifically for rehabilitation for patients of CAM (covid associated mucormycosis), its methods, advantages and limitations.

Implant therapy in a higher education institution: changes or paradigms?

Since the 1970, dental rehabilitation of partially or totally edentulous patients has been an increasingly used practice, due to improved materials and methods and high rates of survival and success. Objective: This study aimed to evaluate patients from the Faculty of Dentistry of the University of Passo Fundo, between 2015 and 2018, with indication and installation of dental implants. Material and methods: Data on age and gender of the patients, indication and region of the implants, technique, type of connection and shape of the implants, bone density, need for grafting and image modality used for surgical planning were collected from dentistry records. Results: In total, 55 patients and 105 implants were evaluated. The age group ranged from 21 to 82 years, and women were the majority group (64%). Among the implant indications, 71% of the patients had only one tooth missing, and the lower first molars comprised most of the implants performed (21%). The conventional surgical technique was the most used (86%), as well as the cylindrical shape cone morse model. Conclusion: The proper selection of indications for implants seeks to be based on scientific evidence, and the protocols are essential to achieve high success rates.

33. Long-term Clinical Outcomes Following Free Fibula Flap Reconstruction of Maxillomandibular Defects with Immediate Dental Implant Placement

PURPOSE: Immediate dental implant placement (IDIP) at the time of ablative/reconstructive surgery for maxillomandibular cancer is a novel technique that has yet to be evaluated for its long-term clinical outcomes. This study describes long-term clinical outcomes with IDIP in free fibula flaps (FFF) for oncologic head and neck reconstruction. METHODS: A retrospective review for patients who underwent oncologic FFF reconstruction of mandibular or maxillary defects with and without IDIP was performed. Average length of follow-up and complication rates over two time periods (1-2 years and 2+ years) were analyzed. Patients who were lost to follow-up, died, or have not reached the 1 year postoperative timepoint were excluded. The number of patients who achieved dental rehabilitation in the IDIP cohort was also examined. RESULTS: 99 patients received FFF reconstruction with IDIP, and 120 historical patients received FFF reconstruction alone. The average length of follow-up was significantly longer in the historical group (1498.9±1700.6 days vs. 565.4±397.9 days, p=0.0005). 63/99 IDIP patients achieved dental rehabilitation. There was no significant difference in the complication rates between the IDIP and historical cohorts in either 1-2 year or 2+ year time period. CONCLUSION: IDIP is an effective method for rapidly achieving dental rehabilitation in patients undergoing maxillomandibular reconstruction with FFF. Long-term complications in IDIP patients were not significantly different from the historical cohort. Further studies investigating patient satisfaction and quality of life scores with IDIP are warranted to elucidate the full benefits of this treatment.

FULL ARCH IMPLANT SUPPORTED FIXED PROSTHETIC REHABILITATION FOLLOWING MANDIBULAR RECONSTRUCTION WITH VASCULARIZED FIBULA BONE GRAFT

Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, lot of treatment and prosthetic options have been documented in literature. Full and complete rehabilitation of masticatory function may only be achieved by a final prosthetic restoration, leading to improvement of general well being. We herein report a case of full arch dental rehabilitation of vascularised fibula reconstructed mandible using 5 implants, multiunit abutment and an acrylic titanium hybrid screw retained denture. The hybrid denture helps in compensating the vertical and horizontal bone and soft tissue discrepancy and also allows easy retrievability for maintenance or repair and contributes to healthy peri-implant tissue.

D52. Long-term Clinical Outcomes following Free Fibula Flap Head and Neck Reconstruction with Immediate Dental Implant Placement

PURPOSE: Immediate dental implant placement (IDIP) at the time of ablative/reconstructive surgery for maxillomandibular cancer is a novel technique that has yet to be evaluated for its long-term clinical outcomes. This study describes long-term clinical outcomes with IDIP in free fibula flaps (FFF) for oncologic head and neck reconstruction. METHODS: A retrospective review for patients who underwent oncologic FFF reconstruction of mandibular or maxillary defects with and without IDIP was performed. Average length of follow-up and complication rates over two time periods (1-2 years and 2+ years) were analyzed. The number of patients who achieved dental rehabilitation in the IDIP cohort was also examined. RESULTS: 99 patients received FFF reconstruction with IDIP, and 120 historical patients received FFF reconstruction alone. The average length of follow-up was significantly longer in the historical group (1498.9±1700.6 days vs. 565.4±397.9 days, p=0.0005). 63/99 IDIP patients achieved dental rehabilitation. There was no significant difference in the complication rates between the IDIP and historical cohorts in either 1-2 year or 2+ year time period. CONCLUSION: IDIP is an effective method for rapidly achieving dental rehabilitation in patients undergoing maxillomandibular reconstruction with FFF. Long-term complications in IDIP patients were not significantly different from the historical cohort. Further studies investigating patient satisfaction and quality of life scores with IDIP are warranted to elucidate the full benefits of this treatment.