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

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  • Hiromi Hirohata
    Oral and Maxillofacial Surgery, Clinical Sciences, Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan
  • Toru Yanagawa
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Shohei Takaoka
    Oral and Maxillofacial Surgery, Clinical Sciences, Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan
  • Kenji Yamagata
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Kaoru Sasaki
    Department of Plastic and Reconstruction Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Yoichiro Shibuya
    Department of Plastic and Reconstruction Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Fumihiko Uchida
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Satoshi Fukuzawa
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Katsuhiko Tabuchi
    Department of Neurohealth Innovation, Institute for Biomedical Sciences Interdisciplinary Cluster for Cutting Edge Research, Department of Molecular & Cellular Physiology Shinshu University School of Medicine Matsumoto Japan
  • Shogo Hasegawa
    Department of Oral and Maxillofacial Surgery, Department of Maxillofacial Surgery, School of Dentistry Aichi Gakuin University Nagoya Japan
  • Naomi Ishibashi‐Kanno
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Mitsuru Sekido
    Department of Plastic and Reconstruction Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
  • Hiroki Bukawa
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan

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<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>Reconstruction 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.</jats:p></jats:sec><jats:sec><jats:title>Material and Methods</jats:title><jats:p>From 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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Kaplan–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).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>A 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.</jats:p></jats:sec>

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