Dental reconstruction after mandibulectomy?

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Could anyone share their experience of having dental implants after a mandibulectomy? Last May I had a mandibulectomy where the fibula from my right leg was used for reconstruction. Implants couldn't be inserted at the time and I also have no teeth either on upper left side as they had to be removed before surgery. I have been having discussions with my consultant about next steps and I'm trying to weigh up the pros and cons of having further surgery. 

Any thoughts gratefully received 

Many thanks

Eliza 

  • Hi Eliza, I had a partial mandibulectomy as well in July last year. They removed a couple of teeth on the lower jaw where they were replacing it with the fibula. At the time a restorative dentist came in at the end of the surgery and put a couple of posts in - one in that area and one more for a tooth that had been removed years before. I also had radiotherapy in October and November but in January I went back to have the tooth planned for. They added the tooth to the old area BUT the other post unfortunately had come loose from the new jaw bone as the new bone had receded. No biggy for me to be honest as I am chewing on the side where I didn’t have surgery. They did say though that it would not be viable to do anything else in the new part of my jaw. Not sure if that helps but in my case they are very reticent about doing anything more in the area of the surgery. How is your overall recovery going, if you didn’t have any radiotherapy it might be a different scenario 

  • Hi Eliza. I had a right mandibulectomy in 2013 but it was only partial as I did not need a reconstruction. Consequently I have a very thin bit of bone left in my right mandible. There is not enough bone for implants so I went down the path of a denture. However it was so uncomfortable that in the end I gave up on it and am now happily gappy. At that stage it did not affect my eating as I could chew on the left side of my mouth. Since then I have had 2 maxillectomies and now have an upper denture. I am now unable to chew as a result so am on a pureed diet. I realise how difficult it is not to have enough teeth to help with chewing which is maybe be where you are at the moment. 

    It is a difficult decision trying to decide about further surgery. Would implants help with your eating? Are you happy with the aesthetics of not having lower teeth on one side? Could you try a denture first to see if that would work? You might have more success than I did with mine. Sorry I'm not much help but I have never regretted not having teeth in my right lower jaw as for me the options were limited so implants not an option. I hope someone else on the forum has had implants in their lower jaw and can give you some info on their experience.

    Best wishes

    Lyn

    Sophie66

  • Thank you so much for replying Gsterc7a3c6. I'm doing OK recovering slowly but surely. Still have pain in my face, mouth and jaw joint as well as my left leg but meds mostly helping. I didn't have radiotherapy. My consultant together with my reconstruction dentist have discussed surgery as a possibility but it would be complex and there would be no guarantees that it would work.  As I say I'm just weighing up the pros and cons. How is your recovering?

    Best wishes

    Eliza

  • Thank you so much for replying Lyn. I asked about dentures but not an option. I can either leave things as they are or have surgery to put in dental implants and remove some scar tissue. I'm not considering surgery for any cosmetic reasons. I'm getting used to my wonky smile! It's really to help with the pain that I'm having. Eating is difficult as I don't have any teeth on my left side and the teeth that I do have don't align properly or not as they once did. Implants might help, however I've been told surgery isn't guaranteed to work. I'm not sure what to decide.

    Best wishes

    Eliza

  • Good to hear you are doing well, it’s a long haul so be kind to yourself on the way (something I am trying to learn). I was very blessed with how I was post surgery pain wise once I got home from hospital, I had some paracetamol overnight for a couple of weeks but that was it. I really did recover well. Still have lymphoedema under my chin which is frustrating but is for life and the inside of my mouth still feels horrible. However a lot of that was made worse by the radiotherapy which I didn’t have to have but decided to as the cancer was very aggressive and even though my surgeon got it all out with good margins and there was no spread to my lymph nodes, I decided to go for the belt and braces. I was at my consultant 2 weeks ago and he was very happy with how I’m doing but said it would be another 8 months before I would get to where I would be long term which was a bit frustrating. I’ve got some other niggly things  I am dealing with but really doing very well.

    i really can only chew on one side of my mouth and don’t see that changing so for me having my more teeth on the other side wouldn’t make a difference so even if it was possible I probably wouldn’t do it.

    it must be a difficult decision for you to weigh up so hope you find a way through and get good advice.

  • Wonderful to hear your recovery is going so well. The surgery, I'm sure you'll agree was really brutal but we survived it! This surgery wouldnt be nearly so drastic but I don't know if I can face going through more. Still if it alleviates the pain it might be worth it. Then again I'd hate to go through it only for it to fail. Sorry for whinging. I need to get this into perspective. I'm sure I'll make the right choice.

    Best wishes

    Eliza