Combining Surgery For Removal Of Tissue And Reconstruction Benefits Patients
Restoring people’s health and returning them to their daily lives as soon as possible is the goal following any surgery. When a person’s ability to eat and speak is affected, as with cancer in the mouth, surgery is particularly disruptive, creating a greater challenge. A one-step surgery can remove cancerous tissue and reconstruct bone and teeth functionality immediately, positively impacting the patient’s quality of life.
A case study in the June issue of the Journal of Oral Implantology describes a one-step surgery performed on a 65-year-old woman with squamous cell carcinoma. A two-year follow-up of this patient showed the one-step procedure to be successful.
Typically, ablative surgery is first performed to remove cancerous bone and tissue. The surgery is followed by radiotherapy, and often tooth loss. Reconstructing the jaw and placing a dental implant at this point are taxing due to the side effects of radiotherapy and poor patient tolerance.
The procedure outlined in this article permitted an impression to be taken immediately after the jaw reconstruction and implant installation during the initial surgery. A rigid prosthesis was fabricated and screw-secured to the implants 48 hours later. Complementary radiotherapy began six weeks following the surgery and implant. The prosthesis was modified as necessary six months after completion of the radiotherapy.
The advantages of single surgery include a reduced risk of osteonecrosis disease in the jawbone which can occur with postradiation surgery. A single surgery also can decrease the need for hyperbaric oxygen therapy.
The authors emphasize that this one-step surgery is possible because it respects the concepts of basal implantology. “Absolute primary implant stability and fabrication of a highly rigid prosthesis are essential from the outset,” they conclude.
Full text of the article, “Immediate Functional Loading of an Implant-Supported Fixed Prosthesis at the Time of Ablative Surgery and Mandibular Reconstruction for Squamous Cell Carcinoma,” Journal of Oral Implantology, Volume 36, Issue 1, 2010
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