Evaluation of use of acrylic resin-based surgical guide in the function and quality of life provided by mandibular prostheses with microvascular free fibula flap: A four-year, randomized, controlled trial

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• 作者：Thais Bianca Brandã ; o ; DDS ; MSc^a ; ^{thais.brandao@icesp.org.br" class="auth_mail" title="E-mail the corresponding author} ; Aljomar José ; Vechiato Filho ; DDS ; MSc^b ; Ana Carolina Prado Ribeiro ; DDS ; MSc ; PhD^c ; Eloisa Maria Mello Santiago Gebrim ; DDS ; MSc ; PhD^d ; Anne-Gaë ; lle Bodard ; DDS ; MSc ; PhD^e ; Dorival Pedroso da Silva ; DDS ; MSc ; PhD^f ; Alan Roger Santos-Silva ; DDS ; MSc ; PhD^g ; Luiz Carlos Ishida ; DMD ; MSc ; PhD^h ; Reinaldo Brito Dias ; DDS ; MSc ; PhDⁱ
• 刊名：The Journal of Prosthetic Dentistry
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：116
• 期：3
• 页码：457-463.e2
• 全文大小：1230 K

文摘

The correct positioning of the microvascular-free fibula flap (MFFF) is essential for satisfactory mandibular reconstruction. However, the effect of acrylic resin-based surgical guides on prosthetic rehabilitations has not yet been properly investigated.

Purpose

The purpose of this randomized clinical trial was to evaluate whether intraoral and extraoral acrylic resin-based surgical guides improve anatomic, functional, esthetic, and quality of life (QoL) results for dental prosthetic rehabilitation with MFFF.

Material and methods

Participants subjected to mandibular reconstruction with MFFF were selected and randomly distributed into 2 groups, control (Co; using conventional surgery) and acrylic resin-based surgical guides (Sg). Functional parameters related to prosthetic rehabilitation and QoL were evaluated by interviews and an oral health impact profile (OHIP)-14 questionnaire. Functional parameters and questionnaire scores were subjected to statistical analysis: the likelihood ratio and the Fisher exact and Mann-Whitney U tests (α=.05).

Results

Of 40 participants, 18 were rehabilitated, 10 with tooth-tissue-supported partial removable dentures and 8 with implant prostheses. In Sg, the study measured an enhancement in functional parameters and revealed a significant improvement in QoL (P=.020).

Conclusions

The guides proposed directly improved mandibular reconstruction. Functional aspects may be improved by allowing good intermaxillary relationships and posterior dental rehabilitation. Functional success is directly dependent on soft tissue status and the quality of its reconstruction. Soft tissue evaluation is important before dental rehabilitation.