The past 50 years have seen a significant renaissance in surgical techniques in the management of oral cavity reconstruction. The first phase in reconstruction used local flaps with non-vascularized free grafts. The resultant functional and cosmetic outcome was often poor with an associated significant mortality due to tissue necrosis, flap failure, and severe nutritional depletion. The classic "Andy Gump'' deformity reminds us of the limitations in reconstruction during this period.

The second phase commenced with the development of the pedicled myocuta-neous and free tissue transfer. This period resulted in a significant reduction in mortality and improved quality of life in this patient population.

The third phase resulted in neural reinnervation of free tissue transfer and state-of-the-art oral rehabilitation with osseointegrated dental implants and prosthetics.

These reconstructive innovations have permitted the successful and reliable use of combined therapy with either pre- or post-operative chemoradiotherapy in an attempt to improve both survival and quality of life in patients with oral cavity malignancies.

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