A COMPARISON OF MASTICATORY FUNCTION IN PATIENTS WITH OR WITHOUT RECONSTRUCTION OF THE MANDIBLE

Background. The functional benefits of mandibular reconstruction follo wing a composite resection remain unclear. Although microvascular surg ical techniques have dramatically increased the predictability of bone and soft-tissue reconstruction towards presurgical anatomic norms, th e specific factors responsible for improved function remain controvers ial. Objective measures of masticatory function need to be more clearl y determined before the predictability and efficacy of reconstructive approaches is established. Methods. We evaluated objective measures of oral function and patient reports of function in 10 reconstructed man dibulectomy patients, 10 without reconstruction, and 10 controls. Meas ures of oral function included bite force assessed at the first molar and incisal edge, a measure of tongue and cheek function, and patient reports of food they could eat. Results. Both reconstructed and nonrec onstructed patients presented decreased biting force, a more restricte d diet, and compromised cheek and tongue function as compared with nor mals. However, reconstructed patients had significantly better measure s of tongue function and ability to eat a varied diet than did nonreco nstructed patients. Of the objective measures used to measure masticat ory performance, bite force was poorly correlated, whereas measures of tongue function strongly correlated with successful mastication. Conc lusion. Both reconstructed and nonreconstructed patients presented wit h a significant functional deficit when compared with normals, with re constructed patients having better overall function than nonreconstruc ted patients. (C) 1997 John Wiley & Sons, Inc.