Techniques for Accomplishing Dental Restoration Among Head and Neck Cancer Patients

PROGRAM DESCRIPTION: Reconstruction of the mandible and midface has drastically changed over the past two decades with the advent of osteocutaneous free flaps. While creating a stable reconstruction and a safe wound was the ultimate goal of bony reconstruction, technologic advancements in our field have pushed the boundaries of what is possible. Completing immediate dental restoration in patients with head and neck cancer can greatly improve quality of life and increases the likelihood that a patient will have a prothesis placed. In addition, placement of dental implants prior to adjuvant radiation therapy can reduce risk of implant failure, thus, integrating this approach into one's reconstructive algorithm is of great benefit to patients. A successful dental restoration program requires interdisciplinary coordination, and access to virtual surgical planning or the technical skills to perform free-hand implantation. The goal of this one-hour panel is to discuss how to approach dental restoration among head and neck cancer patients. The panelists will discuss a clinical decision-making algorithm that enables surgeons to have a method for determining who could be a candidate for immediate dental restoration, as well as who is best served with more conservative measures. Part of this discussion will include how to manage patients undergoing adjuvant treatment. A brief didactic session will be held, followed by a series of complex cases, including both midface and mandible reconstructive challenges. The discussion will be led by a multidisciplinary team, including head and neck surgery, oral surgery, and a prosthodontist. The goal of this panel is to create a template for a dental restoration program that can be applied to any center caring for patients with complex head and neck reconstructive needs.

OUTCOME OBJECTIVE 1: To discuss candidacy criteria for immediate dental restoration among patients undergoing reconstruction of the midface and mandible.

OUTCOME OBJECTIVE 2: To demonstrate techniques that enable patients to undergo successful dental restoration, including necessary preoperative work-up and intraoperative collaboration between specialties.

OUTCOME OBJECTIVE 3: To discuss postoperative care of patients who undergo immediate dental restoration, including timing of postoperative vestibuloplasty and prothesis placement, and how to manage common complications.

BACKGROUND STATEMENT: Currently, there is limited information on how to accomplish dental restoration among H&N cancer patients. Given that these techniques greatly improve quality of life, providing a fund of knowledge on how to build a program would be of beneficial for otolaryngologists in a variety of settings.

Comprehensive Otolaryngology Track Statement :