title: Prosthetic rehabilitation, implant survival and quality of life 2 to 5 years after resection of oral tumors.
abstract: BACKGROUND
  After oral tumor resection, structural and functional rehabilitation by means of dental prostheses is complex, and positive treatment outcome is not always predictable.
  
  
  OBJECTIVE
  The objective of the study was to report on oral rehabilitation and quality of life 2-5 years after resection of malignant oral tumors.
  
  
  METHODS
  Data of 46 patients (57 ± 7 years) who underwent oral tumor surgery were available. More than 50% of tumors were classified T3 or T4. Open oro-nasal defects resulted in 12 patients and full mandibulary block resections in 23 patients. Comprehensive planning, implant placement, and prosthetic rehabilitation followed an interdisciplinary protocol. Analysis comprised tumor location, type of prostheses, implant survival, and quality of life.
  
  
  RESULTS
  Because of advanced tumor status, resections resulted in marked alteration of the oral anatomy requiring complex treatment procedures. Prosthetic rehabilitation comprised fixed and removable prostheses, with 104 implants placed in 28 patients (60%). Early implant loss was high (13%) and cumulative survival rate of loaded implants was <90% after 5 years. Prosthetic plans had to be modified because of side effects of tumor therapy, complications with implants and tumor recurrence. The majority of patients rated quality of life favorable, but some experienced impaired swallowing, dry mouth, limited mouth opening, appearance, and soreness.
  
  
  CONCLUSIONS
  Some local effects of tumor therapy could not be significantly improved by prosthetic rehabilitation leading to functional and emotional disability. Many patients had passed away or felt too ill to fill the questionnaires. This case series confirms the complex anatomic alterations after tumor resection and the need for individual treatment approaches especially regarding prosthesis design. In spite of disease-related local and general restrictions, most patients gave a positive assessment of quality of life.
authors: Assistant professor, Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors: Joannis
authors: J
authors: Katsoulis
authors: postgraduate student, Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors: Janine
authors: J
authors: Fierz
authors: chair, Department of Maxillofacial Surgery, University of Bern, Bern, Switzerland.
authors: Takeyuki
authors: T
authors: IIzuka
authors: chair, Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors: Regina
authors: R
authors: Mericske-Stern
mesh_terms: D000222:Adaptation, Physiological; D000230:Adenocarcinoma / Q000534:rehabilitation / Q000601:surgery; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation* / Q000601:surgery; D003238:Connective Tissue / Q000502:physiology; D015921:Dental Implants / Q000523:psychology; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires
chemical_list: D015921:Dental Implants