Judith A Lam Tang1, Jana M Rieger, Johan F Wolfaardt. 1. Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Department of Speech Pathology and Audiology, Faculty of Rehabilitation Medicine, University of Alberta, Alberta, Canada. judith@ualberta.ca
Abstract
PURPOSE: This review examined literature that reported functional outcomes across 3 categories of prosthetic treatment after microvascular reconstruction of the maxilla and mandible: (1) conventional dental/tissue-supported prosthesis, (2) implant-retained prosthesis, and (3) no prosthesis. MATERIALS AND METHODS: Library databases were searched for articles related to reconstruction of the maxilla and mandible, and references of selected articles were hand searched. Relevant literature was identified and reviewed with criteria specified a priori. RESULTS: Forty-nine articles met the inclusion criteria. Twelve articles reported on function after maxillary reconstruction, with the majority of articles reporting on outcomes for 1 to 6 subjects. Thirty-nine articles reported on function after mandibular reconstruction. Speech outcomes were satisfactory across all groups. Swallowing reports indicated that many patients who received either type of prosthetic rehabilitation resumed a normal diet, whereas those without prosthetic rehabilitation were often restricted to liquid diets or feeding tubes. Patients without prosthetic rehabilitation reportedly had poor masticatory ability, whereas conventional prosthetic treatment allowed some recovery of mastication and implant-retained prosthetic treatment resulted in the most favorable masticatory outcomes. Quality-of-life outcomes were similar across all patients. CONCLUSIONS: Several limitations of the current literature prevented definitive conclusions from being reached within this review, especially regarding maxillary reconstruction. However, recognition of these limitations can direct functional assessment for the future.
PURPOSE: This review examined literature that reported functional outcomes across 3 categories of prosthetic treatment after microvascular reconstruction of the maxilla and mandible: (1) conventional dental/tissue-supported prosthesis, (2) implant-retained prosthesis, and (3) no prosthesis. MATERIALS AND METHODS: Library databases were searched for articles related to reconstruction of the maxilla and mandible, and references of selected articles were hand searched. Relevant literature was identified and reviewed with criteria specified a priori. RESULTS: Forty-nine articles met the inclusion criteria. Twelve articles reported on function after maxillary reconstruction, with the majority of articles reporting on outcomes for 1 to 6 subjects. Thirty-nine articles reported on function after mandibular reconstruction. Speech outcomes were satisfactory across all groups. Swallowing reports indicated that many patients who received either type of prosthetic rehabilitation resumed a normal diet, whereas those without prosthetic rehabilitation were often restricted to liquid diets or feeding tubes. Patients without prosthetic rehabilitation reportedly had poor masticatory ability, whereas conventional prosthetic treatment allowed some recovery of mastication and implant-retained prosthetic treatment resulted in the most favorable masticatory outcomes. Quality-of-life outcomes were similar across all patients. CONCLUSIONS: Several limitations of the current literature prevented definitive conclusions from being reached within this review, especially regarding maxillary reconstruction. However, recognition of these limitations can direct functional assessment for the future.