title: Implant supported dental rehabilitation following segmental mandibular reconstruction- quality of life outcomes of a prospective randomized trial.
abstract: OBJECTIVE
  The primary objective of this study was to assess the difference in quality of life (QoL) in patients with dental rehabilitation using two or four implant-supported overdentures following segmental mandibulectomy defect reconstruction with fibula free flap.
  
  
  METHODS
  This prospective, parallel designed, randomized clinical study was conducted with a 1:1 ratio. At baseline, all participants already had fibula flap reconstruction for segmental defects of the mandible and rehabilitation with conventional (non-implant supported) removable partial dentures. The participants were then randomized into two groups. Group I received implant supported overdentures on two implants, and Group II received four implants. QoL outcomes were evaluated using standardized questionnaires (EORTC_QLQ c30, H&N35, OHIP, DSI). Outcomes of treatment were evaluated at 6 months (T1) and 1 year (T2) following rehabilitation.
  
  
  RESULTS
  A total of 52 patients were randomized into two treatment groups (26 each). After accounting for the loss to lack of follow-up, 22 patients in Group I and 24 patients in Group II were evaluated for QoL at the end of the study. There was a significant improvement in QoL with implant-assisted dental rehabilitation. However there were no significant differences in QoL between the two-implant and four-implant groups.
  
  
  CONCLUSIONS
  Implant-supported removable overdentures improve QoL outcomes in patients with reconstructed mandibles. This study showed no significant difference in QoL outcomes in patients with two- or four-implant supported removable prostheses.
authors.affiliation: Head and Neck Institute, Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India; Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany. Electronic address: veezo@rediffmail.com.
authors.forename: Vinay V
authors.initials: VV
authors.lastname: Kumar
authors.affiliation: Head and Neck Institute, Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India. Electronic address: pcjacob66@gmail.com.
authors.forename: P C
authors.initials: PC
authors.lastname: Jacob
authors.affiliation: Department of Periodontics, M. R. Ambedkar Dental College & Hospital, Bangalore, India. Electronic address: supriyaebenezer@gmail.com.
authors.forename: Supriya
authors.initials: S
authors.lastname: Ebenezer
authors.affiliation: Head and Neck Institute, Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India. Electronic address: makuriakose@gmail.com.
authors.forename: Moni A
authors.initials: MA
authors.lastname: Kuriakose
authors.affiliation: Head and Neck Institute, Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India. Electronic address: kvikram2000@gmail.com.
authors.forename: Vikram
authors.initials: V
authors.lastname: Kekatpure
authors.affiliation: Department of Plastic and Reconstructive Surgery (Head: Prof. Dr. A. S. Baliarsing), BYL Nair Charitable Hospital and Topiwala National Medical College, Mumbai, India. Electronic address: amresh_baliarsing@hotmail.com.
authors.forename: Amresh S
authors.initials: AS
authors.lastname: Baliarsing
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany. Electronic address: Al-Nawas@uni-mainz.de.
authors.forename: Bilal
authors.initials: B
authors.lastname: Al-Nawas
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany. Electronic address: wilfried.wagner@unimedizin-mainz.de.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Wagner
mesh_terms: D019094:Dental Prosthesis, Implant-Supported / Q000523:psychology*; D005260:Female; D005360:Fibula / Q000637:transplantation; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction / Q000523:psychology*; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Dental implants; Free fibula flap; Mandible reconstruction; Oral cancer; Quality of life; Rehabilitation