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Rehabilitation of an irradiated marginal mandibulectomy patient using immediately loaded basal implant-supported fixed prostheses and hyperbaric oxygen therapy: A 2-year follow-up.
Int J Surg Case Rep. 2020; 71:297-302.IJ

Abstract

INTRODUCTION

The prosthetic rehabilitation of mandibular defects owing to tumor resection is challenging, especially when the patient has undergone subsequent radiotherapy.

PRESENTATION OF CASE

A 46-year old male presented with a marginal mandibular resection. Following surgery, the patient received adjunctive radiation therapy with a total dose of 70 grays. On clinical examination, the patient presented with severely resorbed edentulous jaws, with an anterior marginal mandibular resection and an obliterated vestibular sulcus. The panoramic radiograph showed a hypocellularity of the maxillary and mandibular bones. A multidisciplinary team was formed, and a treatment plan was formulated which involved the construction of a vestibuloplast stent, and the application of 20 hyperbaric oxygen sessions before implant treatment and 10 more sessions after implant insertion. A total of 16 basal cortical screw implants were inserted to support the fixed prostheses, and a vestibuloplasty was performed to improve esthetics. No complications were observed, and at the 2-year follow-up, the patient presented with excellent peri-implant soft tissue health; increased bone-implant contact; and stable, well-functioning prostheses.

DISCUSSION

The construction of a stable, retentive, well-supported removable prosthesis may be complicated in cases of comprehensive mandibular resection. Basal implants can eliminate the need for bone grafting, and reduce the treatment period required for providing a fixed prosthesis.

CONCLUSION

To our knowledge this is the first evidence reporting the use of fixed basal implant-supported prostheses in irradiated bone, in conjunction with hyperbaric oxygen therapy. A treatment modality that significantly improves the peri-implant tissue health, and ensures an excellent implant-bone contact.

Authors+Show Affiliations

Assistant Professor, Department of Oral Rehabilitation, Prosthodontics Division, Faculty of Dentistry, University of Khartoum, Sudan. Electronic address: fadiadent@hotmail.com.Assistant Professor, Chair of the Department of Preventive and Restorative Dentistry, University of Sharjah/Faculty of Dental Medicine, Sharjah, Sharjah, United Arab Emirates. Electronic address: nadiakhalifa23@hotmail.com.Associate Professor, International University of Africa, Oral and Maxillofacial Surgery Department, Khartoum, Sudan. Electronic address: nasirjuba@yahoo.com.Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan. Electronic address: newsulaiman@yahoo.com.Consultant, Implant Department, Khartoum Teaching Dental Hospital, Federal Ministry of Heath, Khartoum, Sudan. Electronic address: motazdent@hotmail.com.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32480342

Citation

Awadalkreem, Fadia, et al. "Rehabilitation of an Irradiated Marginal Mandibulectomy Patient Using Immediately Loaded Basal Implant-supported Fixed Prostheses and Hyperbaric Oxygen Therapy: a 2-year Follow-up." International Journal of Surgery Case Reports, vol. 71, 2020, pp. 297-302.
Awadalkreem F, Khalifa N, Ahmad AG, et al. Rehabilitation of an irradiated marginal mandibulectomy patient using immediately loaded basal implant-supported fixed prostheses and hyperbaric oxygen therapy: A 2-year follow-up. Int J Surg Case Rep. 2020;71:297-302.
Awadalkreem, F., Khalifa, N., Ahmad, A. G., Suliman, A. M., & Osman, M. (2020). Rehabilitation of an irradiated marginal mandibulectomy patient using immediately loaded basal implant-supported fixed prostheses and hyperbaric oxygen therapy: A 2-year follow-up. International Journal of Surgery Case Reports, 71, 297-302. https://doi.org/10.1016/j.ijscr.2020.05.018
Awadalkreem F, et al. Rehabilitation of an Irradiated Marginal Mandibulectomy Patient Using Immediately Loaded Basal Implant-supported Fixed Prostheses and Hyperbaric Oxygen Therapy: a 2-year Follow-up. Int J Surg Case Rep. 2020;71:297-302. PubMed PMID: 32480342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rehabilitation of an irradiated marginal mandibulectomy patient using immediately loaded basal implant-supported fixed prostheses and hyperbaric oxygen therapy: A 2-year follow-up. AU - Awadalkreem,Fadia, AU - Khalifa,Nadia, AU - Ahmad,Abdelnasir G, AU - Suliman,Ahmed Mohamed, AU - Osman,Motaz, Y1 - 2020/05/21/ PY - 2020/04/24/received PY - 2020/05/09/accepted PY - 2020/6/2/pubmed PY - 2020/6/2/medline PY - 2020/6/2/entrez KW - Basal implant-supported prostheses KW - Hyperbaric Oxygen KW - Immediately loaded fixed prostheses KW - Mandibular resection SP - 297 EP - 302 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 71 N2 - INTRODUCTION: The prosthetic rehabilitation of mandibular defects owing to tumor resection is challenging, especially when the patient has undergone subsequent radiotherapy. PRESENTATION OF CASE: A 46-year old male presented with a marginal mandibular resection. Following surgery, the patient received adjunctive radiation therapy with a total dose of 70 grays. On clinical examination, the patient presented with severely resorbed edentulous jaws, with an anterior marginal mandibular resection and an obliterated vestibular sulcus. The panoramic radiograph showed a hypocellularity of the maxillary and mandibular bones. A multidisciplinary team was formed, and a treatment plan was formulated which involved the construction of a vestibuloplast stent, and the application of 20 hyperbaric oxygen sessions before implant treatment and 10 more sessions after implant insertion. A total of 16 basal cortical screw implants were inserted to support the fixed prostheses, and a vestibuloplasty was performed to improve esthetics. No complications were observed, and at the 2-year follow-up, the patient presented with excellent peri-implant soft tissue health; increased bone-implant contact; and stable, well-functioning prostheses. DISCUSSION: The construction of a stable, retentive, well-supported removable prosthesis may be complicated in cases of comprehensive mandibular resection. Basal implants can eliminate the need for bone grafting, and reduce the treatment period required for providing a fixed prosthesis. CONCLUSION: To our knowledge this is the first evidence reporting the use of fixed basal implant-supported prostheses in irradiated bone, in conjunction with hyperbaric oxygen therapy. A treatment modality that significantly improves the peri-implant tissue health, and ensures an excellent implant-bone contact. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/32480342/Rehabilitation_of_an_irradiated_marginal_mandibulectomy_patient_using_immediately_loaded_basal_implant_supported_fixed_prostheses_and_hyperbaric_oxygen_therapy:_A_2_year_follow_up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(20)30318-7 DB - PRIME DP - Unbound Medicine ER -
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