Mandibulotomy and implant insertion.
BACKGROUND
A mandibulotomy can be necessary to approach a tumor in the oral cavity or oropharynx. The aim of this study was to develop and prospectively evaluate a technique enabling simultaneous performance of a mandibulotomy and insertion of endosseous implants in the same area.


METHODS
In five edentulous patients such a procedure was performed. The pilot drilling of the implants was done before performing the mandibulotomy. After tumor resection, reconstruction, and restoration of the continuity of the mandible, the final drilling and insertion of the implants were completed. In total, 20 implants were inserted. All patients received radiation therapy within 6 weeks after surgery. Implant-supported overdentures were fabricated 6 months after irradiation. At regular time intervals, a standardized clinical and radiographic evaluation was performed.


RESULTS
No complications with respect to the combination of implant insertion and mandibulotomy were observed either during or after surgery. In addition, no adverse mucosal reactions were observed during the course of radiotherapy, no cases of osteoradionecrosis developed, and no implants were lost. Clinical and radiographic evaluation revealed healthy peri-implant parameters.


CONCLUSIONS
From this study it is concluded that, when following the technique described, a mandibulotomy can be combined safely with the insertion of implants in the ventral part of the edentulous mandible.
Schoen
Pieter J
PJ
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Hospital Groningen, P. O. Box 30.001, 9700 RB Groningen, The Netherlands. p.j.shoen@kchir.azg.nl
Raghoebar
Gerry M
GM
Vissink
Arjan
A
Roodenburg
Jan L N
JL
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D019930:Mandibular Prosthesis Implantation / Q000379:methods*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome