A small number of residual teeth after the mandibular resection of oral cancer is associated with titanium reconstruction plate exposure

Abstract

ObjectiveReconstruction plates are used to treat patients with a segmental mandibular defect after oral cancer surgery. Reconstruction plate failure analysis has rarely focused on occlusion, which conducts a mechanical force to the mandible and the plate. To determine the prognostic factors, we retrospectively evaluated patients who underwent reconstruction of a mandibular segmental defect with a reconstruction plate and assessed the number of residual paired teeth.Material and MethodsFrom among 390 patients with oral cancer who visited University of Tsukuba Hospital (Tsukuba, Japan) between 2007 and 2017, we selected and analyzed the data of 37 patients who underwent segmental resection of the mandible and reconstruction with reconstruction plates. Prognostic factors evaluated were patient age, sex, TNM classification, plate manufacturer, treatment with radiotherapy or chemotherapy, whether the patient had diabetes or smoked, and whether the patient had a small number of residual paired teeth, plate length, and use of a fibular‐free flap. Among these 37 patients, eight reconstruction plates had intraoral or extraoral exposure and were removed in 5 years.ResultsKaplan–Meier and log‐rank analyses revealed that the prognosis for the 5‐year plate exposure‐free rate was significantly poorer for patients with a small number of residual teeth than for patients with no teeth or those with a large number of residual teeth (.01). Univariate Cox regression analysis revealed that a small number of residual teeth was a significant prognostic factor in the loss of a reconstruction plate (hazard ratio: 5.63; 95% confidence interval [1.10, 25.85]; .04).ConclusionsA small number of residual teeth after the segmental resection of oral cancer is significantly involved in reconstruction plate survival and may be important in predicting reconstruction plate prognosis.

Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

“…In defect size quartile three, between 61 and 90 mm, most frequent complications were exposed plates in the healing process. The literature indicates that a low number of residual teeth is a significant prognostic factor for reconstruction plate loss (53). The results of this study are consistent with the literature as bone loss in the 61-90-mm range is associated with loss of dentition.…”

The combination of a 3D-Printed porous Ti–6Al–4V alloy scaffold and stem cell sheet technology for the construction of biomimetic engineered bone at an ectopic site

“…5 A–C. After 12 weeks of implantation, macroscopic views of the subcutaneous implantation sites revealed that the larger amount of ECM in osteoblastic BMSC sheets or produced during the coculturing of BMSCs and PT scaffolds in osteogenic medium markedly increased the biocompatibility of PT scaffolds and decreased the risk of metal exposure in PT/HC and PT/CS groups, which commonly occurs in patients who received titanium alloy plate for the immediate repair of postoperative defects after the removal of mandibular malignant tumors [ 42 ]. In contrast, the implanted PT scaffolds in the PT/LC group were almost completely exposed ( Fig.…”

In Vivo Bone Tissue Engineering Strategies: Advances and Prospects

“…Complications predominantly include fractures, instability, extrusion, and rejection of implants. Furthermore, custom-made implants are associated with consequential financial costs [ 12 , 13 , 14 ].…”