Modified treatment procedure for prosthetic rehabilitation of tumor patients

Purpose: The oral rehabilitation of tumor patients, having undergone oral cancer treatment, often suffers from disorders of mastication and articulation. After the resection of tumors resulting defects concern not only the alveolar bone but also the mobility of the tongue, the floor of the mouth and the soft tissue. In this clinical report we demonstrate a simple and effective surgical and prosthetic treatment procedure to improve the condition of the soft tissue around the implants and prevent the muscle attachment near the implants. Material and methods: We treated 10 tumor patients with 41 implants. At implant placement a closed impression was taken from the implants for the fabrication of a surgical implant retained splint. At second stage surgery a modified vestibuloplasty enhancing tongue mobility and gaining attached gingiva using a 0, 4 mm split- thickness skin graft from the upper thigh was performed. After proper placement of the graft the modified surgical splint is screwed to the implants to allow pressure on the graft and to avoid shrinkage or repositioning of the removed muscles or mucosa. The splint is removed when the definitive restoration is placed. Results and conclusion:In the first series of patients treated with this method the resultsdemonstrate an adequately deepened and long-term stable vestibulum. Afterinsertion of the bar retained prosthesis all patients show an improvement inspeech, deglutition and oral competence. Oral hygiene can easier beperformed. This vestibuloplasty offers a safe and convenient method torestore the mobility of the tongue and to gain a sufficient basis forprosthetic management. Keywords: oral cancer, vestibuloplasty, prosthetic rehabilitation