Long‐Term Health‐Related Quality of Life After Jaw Reconstruction With Fibula Free Flaps Using Primary Endosseous Implants and Buried Skin Grafts to Facilitate Implant‐Retained Dental Prostheses

Abstract

ABSTRACT Background Data on health‐related quality‐of‐life (HRQoL) is indispensable in understanding patient outcomes following jaw reconstruction. This study aims to evaluate long‐term HRQoL using validated patient‐reported outcome measures (PROMs) following jaw reconstruction using buried skin grafts to facilitate implant‐retained dental prosthetic rehabilitation. Methods A cohort study of all patients that underwent prelamination as described by Rohner or the Sydney Modified–Alberta Reconstruction Technique (SM‐ART) from October 2012 to June 2023 at Chris O'Brien Lifehouse, Sydney, Australia with HRQoL data was conducted. HRQoL was assessed using the FACE‐Q Head and Neck Cancer Module, MD Anderson Dysphagia Inventory (MDADI), and Speech Handicap Index (SHI) at one‐year intervals from baseline to 5 years post‐operatively. Results Twenty‐eight cases (Rohner technique; n = 19 or SM‐ART; n = 9) were included (median age, 52 years). Six dental implant losses were recorded across five patients (median time to implant loss, 21.5 months). Three patients required denture removal; however, all had an implant‐retained prosthesis at end of follow‐up. While cross‐sectional HRQoL scores were lower across most subscales at 12 months post‐operatively as compared with baseline, mean scores among available respondents showed favourable trends towards baseline by 60 months. Appearance distress notably improved beyond baseline (mean difference [MD] +19.9, 95% confidence interval [CI] −4.1 to 43.9), while oral competence (MD −16.6, 95% CI −53.4 to 20.2) and eating distress (MD −8.5, 95% CI −50.3 to 33.3) suggested a more persistent deficit. Conclusions Favourable trends in long‐term HRQoL were observed following these reconstructive techniques to optimise dental rehabilitation, although long‐term estimates should be interpreted cautiously. These data may help inform patient counselling regarding the anticipated trajectory of recovery.