Implant supported dental rehabilitation following segmental mandibular reconstruction- quality of life outcomes of a prospective randomized trial

J Craniomaxillofac Surg. 2016 Jul;44(7):800-10. doi: 10.1016/j.jcms.2016.04.013. Epub 2016 Apr 16.


Purpose: 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.

Material and 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.

Conclusion: 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.

Keywords: Dental implants; Free fibula flap; Mandible reconstruction; Oral cancer; Quality of life; Rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dental Prosthesis, Implant-Supported / psychology*
  • Female
  • Fibula / transplantation
  • Follow-Up Studies
  • Free Tissue Flaps / transplantation
  • Humans
  • Male
  • Mandibular Reconstruction / psychology*
  • Patient Reported Outcome Measures
  • Prospective Studies
  • Quality of Life*
  • Surveys and Questionnaires