37 Mandibular Dentures in Head and Neck Cancer Patients 2 Discussion According to the Dutch guidelines for the treatment of head and neck cancer, many patients are bound to lose some or even all of their teeth. Prosthetic rehabilitation in these cases is mostly done with partial or complete dentures. Today, the Dutch health care system supplies two interforaminal dental implants in the mandible for patients having trouble using their dentures and who have a strongly resorbed mandible. In comparison to the literature, good results were registered, with 88.3% (45 of 51, Table 3) of mandibular dentures in function after a variable time of followup (range: 1 to 23 years) (Table 1) [10, 11]. The overall denture satisfaction in the examined population was relatively high, with a mean of 7.3 out of 10. This is comparable to other studies of patients with oral cancer as well as of healthy patients [9, 10, 17]. Prospective randomized studies show that patients are more satisfied with an IOD comparing to a CD [13]. This study on irradiated head and neck cancer patients also found a better, but non significant, overall mandibular denture satisfaction for IOD rehabilitation. The only significant factor found was “retention”. If we split the group into men and women, the men scored significantly higher in “overall mandibular denture satisfaction” and “mandibular denture”. In the women’s group, no significant difference between IODs and CDs was noted. These results may have been influenced by the fact that the women more frequently underwent surgery. Only 17 of 32 (53%) men underwent surgery, but 15 out of 18 (83%) women did. Unfortunately, the remaining group of women that were only irradiated was too small to confirm these assumptions. Comparable differences were also found between men and women in the Pan et al study [17]. However, Pan et al found these differences in the CD group, whereas the present study found them in the IOD group. Although the present group was compromised by the oncological treatment, it can be concluded that women are less satisfied with their dentures than men. Concerning the items “appearance and speaking”, surgical patients scored worse than irradiation only patients. Significance was found for patients after continuity resections of the mandible. The items “eating and speaking” were
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