Factors Affecting Dental Rehabilitation Following Jaw Reconstruction With Free-Fibular Graft In Patients With Head and Neck Cancer

Existing anatomic factors play a significant role in affecting the possibility of dental rehabilitation in head and neck cancer patients undergoing free-fibular graft reconstruction. An observational, cross-sectional study was initiated to evaluate factors affecting dental rehabilitation following free-fibular graft jaw reconstruction in head and neck cancer patients. Patients who had undergone jaw reconstruction with free-fibular graft, requiring dental rehabilitation were recruited. Irradiated, reconstructed patients who had completed at least 1 year since the last dose of radiotherapy and nonradiated patients who had completed 6 months since reconstruction were recruited. Patients who had undergone soft-tissue reconstruction or free-fibular graft in non-condyle sparing resections were excluded. Patient's demographic data, disease and treatment-related data were obtained. An intra-oral examination was carried out to evaluate anatomic variables affecting dental rehabilitation. Descriptive statistical analyses were carried out to study demographic data. Logistic regression analysis was carried out using Pearson chi(2) test and Fisher exact test. Estimates of regression coefficient and their standard errors with 95% confidence interval were calculated. Total of 138 patients were enrolled and considered for prosthetic rehabilitation. A review of the frequency-based data revealed that 30% (n = 41) patients were considered suitable for prosthetic rehabilitation. On multivariate logistic regression analysis, morbidity of radiotherapy (P = 0.01), interference to placement of implants by reconstruction plates and screws (P = 0.023), unfavorable diagnostic maxilla-mandibular relationship (P = 0.011), and obliterated vestibule (P = 0.001) were statistically established (P<0.05) as the most significant reasons for not carrying out dental rehabilitation in patients who had undergone free-fibular graft reconstruction.