Mandibular Reconstruction after Head and Neck Tumor Treatment, a Systematic Review

Abstract: Objectives This systematic literature review examined the literature about mandibular reconstruction after cancer treatment with segmental resection, with focus on  success rate for the reconstruction, patient survival rate, dental rehabilitation and how this effect the patients QOL, oral function and aesthetics.   Material and methods A search was performed in Pubmed, a database of scientific articles, based on four keywords (Mandibular, Reconstruction, Cancer, Segmental). After screening using our inclusion and exclusion criteria’s, 89 articles were chosen. A data base in excel was established to sort the information we needed for our study.     Results Sixty out of the 89 included articles were in full text and 29 were abstracts. The median year of publication was 2006 (range 1977 to 2013). A total of 5629 patients were included in the literature review. Of these, 3783 patients were included in articles that had categorized by gender and we found that 65.4% were males and 34.6% were females. The total success rate for reconstruction therapies including plate, vascularized- and non-vascularized bone transplant was 86.4% in 3219 patients (range from 70.4% in the plate group to 92.3% in the non-vascular group). The mean follow up time were 46.9 mounts (range 0.2 – 216 months).   Conclusion This literature review indicates a focus on success rates for different kinds of reconstruction techniques. The overall success rate for non- and vascularized bone reconstruction techniques were very high compared to plate reconstruction only. To evaluate patient-related factors such as function, aesthetics and quality of life, further prospective randomized studies is required.