Long-term outcome of patients with or without osseointegrated implants after resection of mandibular ameloblastoma and reconstruction with vascularized bone graft: Functional assessment and quality of life

Publication date: July 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery, Volume 71, Issue 7

Author(s): Marco Pappalardo, Chung-Kan Tsao, Man Lung Tsang, Jie Zheng, Yang-Ming Chang, Chi-Ying Tsai

Summary

Background

The optimal management after the resection of mandibular ameloblastoma has been very challenging to surgeons. The aim of this study is to evaluate the functional, aesthetic, and quality of life outcomes of patients who had a segmental mandibular resection and immediate reconstruction with or without osseointegrated implants.

Method

Patients' demographics, tumor characteristics, treatment, and complications were retrieved. Patients were divided into two groups: dental rehabilitated vs. nondental rehabilitated depending on the placement of osseointegrated implants followed by an implanted-retained prosthesis. Functional outcomes and quality of life were assessed using the Performance Status Scale, the University of Washington Quality of Life (UW-QOL) scale, and the 14-item Oral Health Impact Profile (OHIP-14). Aesthetic outcome was evaluated by patients using a Visual Analog Scale.

Results

Thirty-four patients were reviewed. Twenty-two patients were included in the dental rehabilitated group and 12 in the nondental rehabilitated group. No recurrence of the tumor was found during the average follow-up period of 7.4 years. Although both groups reported a similar satisfaction in appearance, patients in the dental rehabilitated group scored significantly higher in masticatory function and "eating in public" (p < 0.01). There were significant differences (p < 0.05) regarding "chewing," "activity," and "anxiety" when assessed using the UW-QOL scale. Indeed, patients in the dental rehabilitated group showed a definitively better outcome in "physical disability" and "psychological discomfort" dimensions when assessed using the OHIP-14.

Conclusion

Vascularized bone graft reconstruction followed by immediate or delayed placement of osseointegrated implants showed as an ideal and predictable treatment modality for patients with ameloblastoma. The results suggested that patients with osseointegrated implants had a significantly better masticatory function, improved quality of life, and less psychological consequences.