title: Evaluation of use of acrylic resin-based surgical guide in the function and quality of life provided by mandibular prostheses with microvascular free fibula flap: A four-year, randomized, controlled trial.
abstract: BACKGROUND
  The correct positioning of the microvascular-free fibula flap (MFFF) is essential for satisfactory mandibular reconstruction. However, the effect of acrylic resin-based surgical guides on prosthetic rehabilitations has not yet been properly investigated.
  
  
  OBJECTIVE
  The purpose of this randomized clinical trial was to evaluate whether intraoral and extraoral acrylic resin-based surgical guides improve anatomic, functional, esthetic, and quality of life (QoL) results for dental prosthetic rehabilitation with MFFF.
  
  
  METHODS
  Participants subjected to mandibular reconstruction with MFFF were selected and randomly distributed into 2 groups, control (Co; using conventional surgery) and acrylic resin-based surgical guides (Sg). Functional parameters related to prosthetic rehabilitation and QoL were evaluated by interviews and an oral health impact profile (OHIP)-14 questionnaire. Functional parameters and questionnaire scores were subjected to statistical analysis: the likelihood ratio and the Fisher exact and Mann-Whitney U tests (α=.05).
  
  
  RESULTS
  Of 40 participants, 18 were rehabilitated, 10 with tooth-tissue-supported partial removable dentures and 8 with implant prostheses. In Sg, the study measured an enhancement in functional parameters and revealed a significant improvement in QoL (P=.020).
  
  
  CONCLUSIONS
  The guides proposed directly improved mandibular reconstruction. Functional aspects may be improved by allowing good intermaxillary relationships and posterior dental rehabilitation. Functional success is directly dependent on soft tissue status and the quality of its reconstruction. Soft tissue evaluation is important before dental rehabilitation.
authors.affiliation: Coordinator, Dental Oncology Service, The State of São Paulo Cancer Institute, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: thais.brandao@icesp.org.br.
authors.forename: Thais Bianca
authors.initials: TB
authors.lastname: Brandão
authors.affiliation: Professor, The State of São Paulo Cancer Institute, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Aljomar José
authors.initials: AJ
authors.lastname: Vechiato Filho
authors.affiliation: Professor, The State of São Paulo Cancer Institute, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Prado Ribeiro
authors.affiliation: Assistant Professor, Institute of Radiology, University of São Paulo, São Paulo, Brazil.
authors.forename: Eloisa Maria Mello Santiago
authors.initials: EM
authors.lastname: Gebrim
authors.affiliation: Assistant Professor, Head and Neck Department, Regional Center Against Cancer Léon Bérard, University Claude, Bernard Lyon I, France.
authors.forename: Anne-Gaëlle
authors.initials: AG
authors.lastname: Bodard
authors.affiliation: Assistant Professor, Department of Surgery, Prostheses and Maxillofacial Traumatology, Dental School of the University of São Paulo, São Paulo, Brazil.
authors.forename: Dorival Pedroso
authors.initials: DP
authors.lastname: da Silva
authors.affiliation: Professor, Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil.
authors.forename: Alan Roger
authors.initials: AR
authors.lastname: Santos-Silva
authors.affiliation: Titular Professor, Department of Plastic Surgery of São Paulo, Faculty of Medicine of São Paulo University, São Paulo, Brazil.
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Ishida
authors.affiliation: Titular Professor, Surgery, Prostheses and Maxillofacial Traumatology, Dental School of the University of São Paulo, São Paulo, Brazil.
authors.forename: Reinaldo Brito
authors.initials: RB
authors.lastname: Dias
mesh_terms: D000180:Acrylic Resins / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D058752:Free Tissue Flaps / Q000601:surgery*; D006801:Humans; D008297:Male; D008341:Mandibular Prosthesis; D063175:Mandibular Reconstruction / Q000295:instrumentation / Q000379:methods; D019919:Prosthesis Implantation / Q000379:methods; D011788:Quality of Life
chemical_list: D000180:Acrylic Resins