Alterations in surgical interventions to improve the prosthetic prognosis in patients with mandibular defects: a review of the literature

Abstract

Aim The present review was aimed to identify the surgical procedures to enhance the prosthetic prognosis in patients with mandibular defects. Methods A literature search was performed on the databases  PubMed/Medline, Scopus, Embase, Google Scholar, Dynamed and Grey Literature, in addition to congress proceedings and books written in Italian or English language. The literature search was conducted using the following keywords: (“prosthesis” or “prosthetic”) AND “prognosis” AND “mandibulectomy”; (“prosthesis” or “prosthetic”) AND “prognosis” AND (“defect” or “reconstruction” or “resection”) and (“mandibular” or “mandible”). Results The selection process yielded 43 papers after the databases search, while 7 books and 3 congress proceedings were included after the manual search. Conclusion To enhance the prosthetic prognosis, the surgeons must preserve the tongue mobility and as many teeth as possible; vestibuloplasty could be needed, while intraseptal bone cuts and specific resection lines are recommended. The use of fibula graft, osseointegrated implants, and digital technologies can improve the prosthetic prognosis.