Dental Prosthetic Rehabilitation of a Tumor Patient AfterRadiotherapy and Mandibular Resection by Soo Jeong Portscher Kim in Surgery & Case Studies Open Access Journal in Lupinepublishers
Background: Many patients with a history of head-and-neck tumors present with hard- and soft-tissue defects resulting from
their disease and treatment that will preclude any dental prosthetic rehabilitation without the use of implants.
Case Report: A 57-year-old male patient with a history of
tonsil and piriform sinus carcinoma sought prosthetic rehabilitation
after successful radio-/chemotherapy and local mandibular resection. His
dentition was severely reduced, consisting of inadequate
crown restorations in the maxillary anterior segment and the mandibular
right canine. The treatment decision was to rehabilitate
the maxilla conventionally and the locally resected mandible with an
implant-supported telescopic denture after extraction of tooth
43. Four implants were placed (32, 33, 42, 43) and allowed to
osseointegrate submerged for 3 months, followed by surgical exposure,
tightening abutments, and cementing conical crowns that served as
primary telescopes. The secondary telescopes consisted of
electroplated copings which were intraorally bonded to the tertiary
structure, thus ensuring a perfect fit of the denture.
Conclusion: Other options for denture retention were
contraindicated: ball or Locator attachments because of the existing
xerostomia and pain from the resection-related scar tissue, and a bar
due to its higher demands on self-performed oral hygiene and
very high requirements for extending the superstructure in the event of
an implant loss. The telescopic denture we provided has
none of these drawbacks, nor does it require any extensive cantilever
saddles because the masticatory loads are largely absorbed
by the implants with almost no force transmission to the mucosa. The
only treatment-related complication was a bony dehiscence,
which was successfully managed by slightly reducing the bone and
harvesting two connective-tissue grafts from the palate to close
the perforation. After one year, the denture continues to be intact and
functional. The patient reported a short period of adaptation
followed by excellently restored function and greatly improved
phonetics.
For more Lupine Publishers Open Access Journals Please visit our
website:
For more Surgery Journal articles Please Click Here:
No comments:
Post a Comment