Functional and aesthetic oral rehabilitation after cancer treatment using dental prosthesis and hyaluronic acid injections: A case report and review of literature

BACKGROUND: Oral cavity cancers are highly invasive malignancies, typically treated with a combination of surgery, radiation, and chemotherapy. Surgical intervention requires the removal of all affected tissues, including the mandibular basal bone. Reconstructive procedures may involve tissue and skin grafts, such as fibula free flaps in the case of mandibulectomy. These techniques aim to minimize scarring and restore basic oral functions. However, radiation therapy may result in fibrotic scarring of the connective tissues. This case report focuses on the integration of surgical, prosthetic, and complementary therapies - including hyaluronic acid (HA) -based filler - to address both functional and aesthetic deficiencies. CASE SUMMARY: The case involves a 70-year-old woman who underwent a right segmental mandibulectomy with fibula free flap reconstruction for pT4aN2b oral squamous cell carcinoma, followed by adjuvant radiochemotherapy. After surgery, she presented to the Odontology Department of Montpellier University Hospital with severe trismus, impaired mastication, and aesthetic concerns, including marked facial atrophy and asymmetry of the face and mouth. The multidisciplinary approach included fluoride trays to address radiotherapy-induced risks, caries treatment, a mandibular partial removable prosthesis for occlusal and soft tissue support, occlusal bonding, and HA injections to restore facial symmetry and improve soft tissue quality. HA was injected into the fibrotic connective tissue to improve skin hydration and counterbalance the asymmetry of the mouth. The combination of prosthetic rehabilitation and HA injections led to significant functional and aesthetic improvements, with a notable positive impact on the patient's sociability and quality of life. CONCLUSION: This case highlights how a multidisciplinary, comprehensive, personalized, and biopsychosocial approach can optimize outcomes in complex oral rehabilitation following oncological surgery.