Functional outcomes with dental prosthesis following simultaneous mandibulectomy and mandibular bone reconstruction

This study sought to ascertain masticatory outcomes in patients who underwent mandibulectomy or hemimandibulectomy together with mandibular bone reconstruction to allow for placement of a removable dental prosthesis. Perioperative changes in masticatory performance, masticatory ability for solids, and patients’ subjective satisfaction were evaluated for 101 patients who had mandibulectomy immediately followed by bone reconstruction. Differences in masticatory performance and masticatory ability for solids after surgery were determined according to occlusal support after surgery and whether the patient was wearing a removable dental prosthesis or not. Occlusal support areas were classified according to Eichner's classification. Preoperative Eichner's class A patients had no experience of wearing a dental prosthesis before surgery and after surgery did not want one. Their masticatory performance was better than that of patients who wanted a dental prosthesis after surgery. Retrospective analysis of postoperative Class B and C patients revealed that masticatory performance was lower in those who wanted a dental prosthesis than in those who did not want one. When patients wore a dental prosthesis after surgery, masticatory performance was markedly improved over not wearing it. All patients’ subjective satisfaction was significantly improved after surgery. Increasing the number of occlusal support areas by wearing a removable dental prosthesis after simultaneous mandibulectomy or hemimandibulectomy and mandibular bone reconstruction may improve masticatory functions. Those professional involved in the rehabilitation for the mandibular defect should be mindful that masticatory functions after such surgeries were affected by the masticatory functions before surgery and the number of occlusal support areas after surgery.