Rehabilitation with dental implants of oral cancer patients (original) (raw)
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Osseointegrated Implant Rehabilitation of Irradiated Oral Cancer Patients
Journal of Oral and Maxillofacial Surgery, 2012
The aim of this study is to analyze implant survival in patients who received radiotherapy treatment for oral malignancies and in patients who had suffered mandibular osteoradionecrosis. Materials and Methods: We reviewed retrospectively 225 implants placed in 30 patients who had received radiotherapy as part of the oncologic treatment. Radiation doses ranged between 50 and 70 Gy. 39 implants were placed after a combined treatment of radiotherapy and chemotherapy. Data referred to tumour type and reconstruction, presence of osteoradionecrosis, region of implant installation and type of prostheses were recorded. Survival rates were calculated with cumulative Kaplan-Meier survival curves and compared between different groups with a log-rank test. Results: 152 osseointegrated implants were placed in patients who presented previous reconstruction procedure. Five patients developed osteorradionecrosis as a complication of the radiotherapy treatment. Once osteoradionecrosis had healed in these patients, 41 implants were installed. The overall 5 year survival rate in irradiated patients was 92.6%. Irradiated patients had a marginally significantly higher implant loss than non-irradiated patients. (p ϭ 0.063). The 5 year survival rate in the osteoradionecrosis group was of 48.3% and in the non-osteoradionecrosis group 92.3%, with a statistically significant difference between both groups. (p ϭ 0.002). Conclusion: Osseointegrated implants enhance oral rehabilitation in most irradiated patients, even being an acceptable option for patients who had suffered osteoradionecrosis. Totally implantsupported prostheses are recommended after irradiation providing functional, stable and aesthetically satisfactory rehabilitation.
Nigerian Journal of Surgery, 2016
In patients undergoing head and neck surgery for various pathologic conditions, implants are one of the best restorative options and are increasingly widely used. [1] The healing process of a wounded, diseased or an injured bone is a normal phenomenon. It begins with fibrin clot formation that alters the normal flow of blood and feeds and supports the osteoprogenitor cells. [2] Successful implant insertion occurs in human bone due to optimum osseointegration at the junction or interface of bone and implants. [3] Most common form of malignancy occurring in humans is the head and neck cancer with over 0.5 million new cases occurring every year. The treatment modality for malignant lesions involves most commonly surgical intervention in combination with radiotherapy. Since, surgical therapy for cancer patients' results in loss of considerable amount of tissue, oral rehabilitation by artificial prosthesis, implants, etc., is a necessary procedure to redress both functional and esthetic disabilities. Artificial prosthesis has certain side-effects such as having the capability of producing xerostomia, mucositis, and altering the healing process in irradiated tissues. Dental implants avoid these side-effects to a much extent but successfully placing implants in patients treated for oral cancer is itself a difficult task because some have had radiation exposure in the tissues. [4] Patients exposed to radiotherapy for treatment of cancer have reduced healing capacity due to progressive fibrosis of vasculature. Radiation
Rehabilitation of oral cancer patients with dental implants
Current Opinion in Otolaryngology & Head and Neck Surgery, 2000
The use of osseointegrated fixtures in conjunction with vascularized bone-containing free flaps has enabled the reconstructive team to restore postablative orofacial defects to near normal appearance and function. A number of flaps have been used in oromandibular reconstruction. Implantability of the bone portion of these flaps together with the soft tissue defect often plays an important role in donor site selection. Controversy as to the timing of fixture placement continues. The proponents of primary placement state that taking advantage of the "window of opportunity" before the radiation damage is essential for increased fixture "survival." Those who favor secondary placement maintain that it not only allows the patient to be disease-free for a period of time before an extensive dental reconstructive procedure is initiated but also leads to better prosthetic planning and hence better fixture placement. The effect of radiation therapy and role of hyperbaric oxygen before treatment have been studied. The results remain inconclusive. This paper reviews the most recent English language literature as it pertains to the use of endosseous root form dental implants in conjunction with vascularized bone flaps in orofacial, postoncologic reconstruction. Curr Opin
A Review of the Success Rate of Dental Implants in Patients Undergoing Radiotherapy and Chemotherapy
ACTA SCIENTIFIC OTOLARYNGOLOGY (ASOL), 2022
Introduction: According to the World Health Organization, the incidence of head and neck cancers, both primary and secondary (metastatic), is increasing. Currently, the main treatments for this complication are radiotherapy and chemotherapy. On the other hand, the success of implant treatment in these patients due to the cellular changes is a very significant point that should be considered. Objective: The aim of this study was to review the success rate of dental implants in patients undergoing radiotherapy and chemotherapy. Materials and Methods: This study was a narrative review. In this study, research published in PubMed, Google Scholar, and Scapus databases has been reviewed by a review method and with a keyword search strategy. Results: 4320 articles were found from the mentioned databases that after deleting unrelated research (3101 cases) and duplicate research (1050 cases), 105 articles remained for final review. Then, those that were presented in the scientific conference and were in the form of abstracts or did not have a correct statistical population were excluded from the study (90 cases). Finally, 15 articles in this study were reviewed. Conclusion: The survival rate of dental implants may be negatively affected by radiotherapy; however, implants can remain osteointegrated and remain functionally stable and, therefore, can be a good treatment option for rehabilitation and improving the quality of life of cancer patients. The use of bone grafts and higher doses of radiation in the jaw area can be negative prognostic factors.
Médecine Buccale Chirurgie Buccale
Introduction: The placement of dental implants in irradiated bone has allowed functional rehabilitation for many oral cancer patients. Nonetheless, there is only few data about implant failure in irradiated tissues and their consequences. This retrospective study aims to highlight the rate and circumstances of implant failure. Material and method: Patients treated with external radiotherapy for oral carcinoma and who received dental implants were included. Patients reconstructed with free bone flaps were excluded. Results: Eighteen patients were included. Forty implants were placed between 2004 and 2007, 8 failed, of whom one osteoradionecrosis was observed. Time interval between radiotherapy and implantation was 44.6 (6–182) months. Mean dose was 51.8 (50–66) Gy. Discussion: In the series, the implant failure rate is 20%, which corroborates the literature's data. Failures occur more often for doses over 50 Gy. The placement of dental implant in irradiated bone leads to soft tis...
Journal of Clinical and Experimental Dentistry, 2021
A 52-year-old female patient with a diagnostic of osteosarcoma in the mandible, in which it was necessary a reconstruction with a microvascularized osteomyocutaneous fibula bone. Coadjuvant chemotherapy was scheduled. Two years later, 4 osseointegrated implants (OII) were placed in the fibula a 2 OII in the right mandible, using a splint guided surgery. The final prosthodontic consisted in a metal ceramic restoration using CAD/ CAM technology. Key words:Oral rehabilitation, oral cancer, head and neck radiotherapy, oral oncology.
The Influence of Radiation Therapy on Dental Implantation in Head and Neck Cancer Patients
Journal of Analytical Oncology
Radiotherapy is used to treat patients with head and neck cancers as a primary therapy or as an adjuvant to surgery or chemotherapy. Irradiation results in several complications that can be very overwhelming to the patient. Frequently there is loss of function due to tooth loss, compromised aesthetics, pain and discomfort from xerostomia and mucositis, it also significantly impacts the quality of life. A major advance in dentistry is the successful rehabilitation and replacement of lost teeth by osseointegrated implants. However, the risk of osteoradionecrosis and failure of osseointegration are barriers to implant therapy for those irradiated patients. The aim of this review article is to primarily find out whether the radiotherapy used in the treatment of head and neck cancer patients can affect the success and survival of dental implants according to different studies, and also, to highlight some other pertinent factors that may concurrently influence these implantation. The prim...
Oral rehabilitation with dental implants in irradiated patients: a meta-analysis on implant survival
Clinical Oral Investigations, 2014
Objectives The aim of this comprehensive literature review is to provide recommendations and guidelines for dental implant therapy in patients with a history of radiation in the head and neck region. For the first time, a meta-analysis comparing the implant survival in irradiated and non-irradiated patients was performed. Material and methods An extensive electronic search in the electronic databases of the National Library of Medicine was conducted for articles published between January 1990 and January 2013 to identify literature presenting survival data on the topic of dental implants in patients receiving radiotherapy for head and neck cancer. Review and meta-analysis were performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses statement. For meta-analysis, only studies with a mean follow-up of at least 5 years were included. Results After screening 529 abstracts from the electronic database, we included 31 studies in qualitative and 8 in quantitative synthesis. The mean implant survival rate of all examined studies was 83 % (range, 34-100 %). Meta-analysis of the current literature (2007)(2008)(2009)(2010)(2011)(2012)(2013) revealed no statistically significant difference in implant survival between non-irradiated native bone and irradiated native bone (odds ratio [OR], 1.44; confidence interval [CI], 0.67-3.