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Crosetti E, Tos P, Berrone M, Battiston B, Arrigoni G, Succo G. Long-Term Follow-Up of Computer-Assisted Microvascular Mandibular Reconstruction: A Retrospective Study. J Clin Med 2024; 13:3899. [PMID: 38999465 PMCID: PMC11242570 DOI: 10.3390/jcm13133899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Virtual surgical planning has become a well-established practice in head and neck surgery. In oncological surgery, it permits the achievement of safe margins resections and ensures functional reconstructions and optimal esthetic outcomes. This study aimed to evaluate the long-term outcomes after virtually planned mandibular microvascular reconstruction, focusing on functional and esthetic results, as well as health-related quality of life. Methods: A long-term retrospective evaluation of 17 patients with oral cavity malignancy who underwent computer-assisted mandibular resection and reconstruction was performed. Functional and esthetic outcomes were analyzed using the EORTC, QLQ-C30, H&N35, and FACE-Q questionnaires. Results: Time since reconstruction ranged from 7 to 14 years. Patients reported high functional levels on the QLQ-C30 functional scales but lower scores on H&N35. On FACE-Q, patients demonstrated higher appraisal and satisfaction with their smiles compared to their overall facial appearance. Conclusions: In this retrospective case series, patients undergoing computer-assisted mandibular reconstruction for oral malignancies achieved good long-term functional and esthetic outcomes. Although limited by the small sample size, these results support the enduring benefits of virtual planning for mandibular reconstruction. To minimize declines in function and appearance, considerations should include immediate dental implants, enhanced reconstruction of the temporomandibular joint, newer methods of radiotherapy to minimize xerostomia, and oral exercises to prevent trismus.
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Affiliation(s)
- Erika Crosetti
- ENT Clinic-Head and Neck Cancer Unit, San Giovanni Bosco Hospital, 10154 Turin, Italy
| | - Pierluigi Tos
- Hand Surgery-Reconstructive Microsurgery Clinic, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122 Milan, Italy
| | - Mattia Berrone
- ENT Clinic-Head and Neck Cancer Unit, San Giovanni Bosco Hospital, 10154 Turin, Italy
| | - Bruno Battiston
- Hand Surgery and Reconstructive Microsurgery Department, CTO Hospital, A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy
| | - Giulia Arrigoni
- ENT Clinic-Head and Neck Cancer Unit, San Giovanni Bosco Hospital, 10154 Turin, Italy
| | - Giovanni Succo
- ENT Clinic-Head and Neck Cancer Unit, San Giovanni Bosco Hospital, 10154 Turin, Italy
- Department of Oncology, University of Turin, 10127 Turin, Italy
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Laverty DP, Addison O, Newsum D, Bateman G. Prosthodontic complications during implant-based oral rehabilitation of patients with head and neck cancer. J Prosthet Dent 2023; 129:366-372. [PMID: 34311947 DOI: 10.1016/j.prosdent.2021.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Implant-retained prosthodontic rehabilitation of patients with head and neck cancer is complex. However, the extent of prosthodontic complications has been sparsely reported within the literature. PURPOSE The purpose of this retrospective study was to describe the range of complications and issues that affected the oral rehabilitation treatment of patients with head and neck cancer who had completed implant-retained prosthodontic rehabilitation in a tertiary treatment center. MATERIAL AND METHODS A retrospective analysis of complications and their consequences in patients treated in a regional unit from 2012 to 2017 was performed. Descriptive analysis was carried out on the type and frequency of complications and their consequences for the patients' treatment. Complications were grouped into the following complication types: local and systemic, implant, peri-implant soft tissue, and clinical prosthodontic complications. Implant success and implant survival were also reported. RESULTS The sample was composed of 163 patients with head and neck cancer who had completed implant-retained prosthodontic rehabilitation. Local and systemic complications affected 8.6% of patients, and peri-implant soft-tissue complications affected 9.8% of patients. Clinical prosthodontic complications leading to repeated clinical or laboratory stages occurred on 48 occasions in 45 patients (27.6% of patients). A total of 763 implants were placed. Implant survival was 95.8% and implant success 94.5%, with a mean follow-up of 42.1 months. CONCLUSIONS This retrospective evaluation indicated that complications arising during the process of implant-retained prosthetic rehabilitation in this patient group were variable and common. Such complications can delay the process of treatment and lead to repeating or restarting clinical and laboratory stages of treatment.
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Affiliation(s)
- Dominic P Laverty
- Consultant in Restorative Dentistry, Restorative Department, University of Birmingham School of Dentistry, Birmingham Dental Hospital, Birmingham, UK.
| | - Owen Addison
- Professor of Oral Rehabilitation, Centre for Clinical, Oral and Translational Sciences, King's College London, London, UK
| | - David Newsum
- Consultant in Restorative Dentistry, Restorative Department, University of Birmingham School of Dentistry, Birmingham Dental Hospital, Birmingham, UK
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Implant-based dental rehabilitation in head and neck cancer patients after maxillofacial reconstruction with a free vascularized fibula flap: the effect on health-related quality of life. Support Care Cancer 2022; 30:5411-5420. [PMID: 35298715 PMCID: PMC9046363 DOI: 10.1007/s00520-022-06944-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/26/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the effect of implant-based dental rehabilitation (IDR) on health-related quality of life (HRQoL) in head and neck cancer (HNC) patients after reconstruction with a free vascularized fibula flap (FFF). METHODS Eligible patients were identified by retrospectively reviewing the medical records of patients treated in Amsterdam UMC-VUmc. HRQoL data were used from OncoQuest, a hospital-based system to collect patient-reported outcome measures in routine care. Data were used of the EORTC QLQ-C30 and QLQ-H&N 35 before FFF reconstruction (T0) and after completing IDR (T1). Data were statistically analysed with the chi-square test, independent samples t test and linear mixed models. RESULTS Out of 96 patients with maxillofacial FFF reconstruction between January 2006 and October 2017, 57 patients (19 with and 38 without IDR) had HRQoL data at T0 and T1. In the cross-sectional analysis, patients with IDR scored significantly better at T0 and T1 on several EORTC domains compared to the patients without IDR. Weight loss was significantly different in the within-subject analysis between T0 and T1 for patients with IDR (p = 0.011). However, there were no significant differences in the mean changes of all the EORTC QLQ-C30 and EORTC QLQ-H&N35 scores between the defined timepoints for patients with IDR compared to those without. CONCLUSIONS In this study, no differences were found in the course of HRQoL in HNC patients who had undergone IDR after maxillofacial FFF reconstruction, compared to those who had not. Patients should be preoperatively informed to have realistic expectations regarding the outcome of IDR.
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Immediate dental implant placement and restoration in the edentulous mandible in head and neck cancer patients: a systematic review and meta-analysis. Curr Opin Otolaryngol Head Neck Surg 2021; 29:126-137. [PMID: 33278135 PMCID: PMC7969163 DOI: 10.1097/moo.0000000000000685] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Oral rehabilitation with dental implants in head and neck cancer (HNC) patients is challenging. After tooth removal prior to radiotherapy, immediate placement of dental implants during panendoscopy or surgery is thought to reduce the oral rehabilitation time improving patients' quality of life. RECENT FINDINGS There is lack of consensus on the timing of dental implant placement and loading protocols. The aim of this study was to perform a systematic review of the literature regarding the performance and survival rate of immediately inserted dental implants placed prior to radiotherapy. Of 1003 articles, 10 were finally included comparing immediate vs. delayed placement of implants and comparing the effect of radiotherapy on immediately placed implants. Meta-analysis demonstrated a slightly higher survival of immediately placed implants compared with postponed placed implants [risk ratio: 0.92, 95% confidence interval (95% CI): 0.48-1.78, P = 0.81, I2 = 0%]. The other meta-analysis comparing radiotherapy vs. nonradiotherapy showed a clearly better survival of immediately placed implants not having received radiotherapy (risk ratio: 5.02, 95% CI: 0.92-27.38, P = 0.10, I2 = 56%). SUMMARY Guidelines are recommended for immediate dental implant placement in the edentulous mandible in HNC patients prior to radiotherapy to allow homogeneity regarding the treatment protocols and thus comparison of treatment outcomes.
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Blasco MA, Cordero J, Dundar Y. Chronic Pain Management in Head and Neck Oncology. Otolaryngol Clin North Am 2020; 53:865-875. [PMID: 32684285 DOI: 10.1016/j.otc.2020.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pain is epidemic in patients with head and neck cancer. Providers involved in the care of patients with head and neck cancer should be able to describe the common pain syndromes experienced by these patients, identify patients at risk of pain, and provide multimodal treatment of chronic pain. Treatment of chronic pain encompasses analgesic medications; adjuvant pharmacotherapy, including antidepressants and anticonvulsants; interventional techniques; as well as integrative medicine.
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Affiliation(s)
- Michael A Blasco
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada
| | - Joehassin Cordero
- Department of Otolaryngology-Head and Neck Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Stop 8315, Lubbock, TX 79430-8315, USA
| | - Yusuf Dundar
- Department of Otolaryngology-Head and Neck Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Stop 8315, Lubbock, TX 79430-8315, USA.
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Vosselman N, Alberga J, Witjes MHJ, Raghoebar GM, Reintsema H, Vissink A, Korfage A. Prosthodontic rehabilitation of head and neck cancer patients-Challenges and new developments. Oral Dis 2020; 27:64-72. [PMID: 32343862 PMCID: PMC7818410 DOI: 10.1111/odi.13374] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/27/2020] [Accepted: 04/20/2020] [Indexed: 01/23/2023]
Abstract
Head and neck cancer treatment can severely alter oral function and aesthetics, and reduce quality of life. The role of maxillofacial prosthodontists in multidisciplinary treatment of head and neck cancer patients is essential when it comes to oral rehabilitation and its planning. This role should preferably start on the day of first intake. Maxillofacial prosthodontists should be involved in the care pathway to shape and outline the prosthetic and dental rehabilitation in line with the reconstructive surgical options. With the progress of three‐dimensional technology, the pretreatment insight in overall prognosis and possibilities of surgical and/or prosthetic rehabilitation has tremendously increased. This increased insight has helped to improve quality of cancer care. This expert review addresses the involvement of maxillofacial prosthodontists in treatment planning, highlighting prosthodontic rehabilitation of head and neck cancer patients from start to finish.
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Affiliation(s)
- Nathalie Vosselman
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Jamie Alberga
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Max H J Witjes
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Harry Reintsema
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Anke Korfage
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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Mandibular dental implant placement immediately after teeth removal in head and neck cancer patients. Support Care Cancer 2020; 28:5911-5918. [PMID: 32279135 PMCID: PMC7686200 DOI: 10.1007/s00520-020-05431-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Little is known about immediate implant placement in head and neck cancer patients. We studied implant survival and functional outcomes of overdentures fabricated on implants placed immediately after removal of the lower dentition during ablative surgery or preceding primary radiotherapy (RT). METHODS Inclusion criteria were primary head and neck cancer, dentate lower jaw, and indication for removal of remaining teeth. Two implants to support a mandibular overdenture were placed immediately after extraction of the dentition during ablative surgery, or prior to starting primary radiotherapy. Standardized questionnaires and clinical assessments were conducted (median follow-up 18.5 months, IQR 13.3). RESULTS Fifty-eight implants were placed in 29 patients. Four implants were lost (implant survival rate 93.1%). In 9 patients, no functional overdenture could be made. All patients were satisfied with their dentures. CONCLUSIONS Combining dental implant placement with removal of remaining teeth preceding head neck oncology treatment results in a favorable treatment outcome.
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Sato N, Koyama S, Mito T, Izumita K, Ishiko R, Yamauchi K, Miyashita H, Ogawa T, Kosaka M, Takahashi T, Sasaki K. Changes in oral health-related quality of life after oral rehabilitation with dental implants in patients following mandibular tumor resection. J Oral Sci 2019; 61:406-411. [PMID: 31341120 DOI: 10.2334/josnusd.18-0234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Oral rehabilitation with prosthodontic treatment considerably influences the well-being and quality of life of patients after ablative oral tumor surgery. This study evaluated the effects of implant-supported prostheses (ISPs) on oral health-related quality of life (OHRQoL) and chewing ability in 10 patients who requested ISPs after mandibular oral tumor resection. OHRQoL was assessed using the Japanese version of the Oral Health Impact Profile (OHIP-49) before and one year after ISP placement. Chewing ability, including self-assessed masticatory ability and occlusal force, was examined at one year after ISP placement. The initial mean total OHIP-49 score of 65.3 ± 9.79 decreased to 46.0 ± 8.14 at one year after ISP placement. Mean OHIP-49 score decreased in all domains, whereas self-assessed masticatory ability increased within one year of ISP placement. There were no significant differences between prosthesis types with respect to the mean OHIP-49 score or self-assessed masticatory ability. In conclusion, ISP placement improves OHRQoL and the self-assessed masticatory ability. Moreover, the prosthesis type might not significantly affect OHRQoL.
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Affiliation(s)
- Naoko Sato
- Tohoku University Hospital, Maxillofacial Prosthetics Clinic
| | - Shigeto Koyama
- Tohoku University Hospital, Maxillofacial Prosthetics Clinic
| | - Takehiko Mito
- Tohoku University Hospital, Maxillofacial Prosthetics Clinic
| | | | - Risa Ishiko
- Tohoku University Hospital, Maxillofacial Prosthetics Clinic
| | - Kensuke Yamauchi
- Division of Oral and Maxillofacial Surgery, Tohoku University Graduate School of Dentistry
| | - Hitoshi Miyashita
- Division of Oral and Maxillofacial Surgery, Tohoku University Graduate School of Dentistry
| | - Takenori Ogawa
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
| | - Moe Kosaka
- Tohoku University Hospital, Maxillofacial Prosthetics Clinic
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery, Tohoku University Graduate School of Dentistry
| | - Keiichi Sasaki
- Division of Advanced Prosthodontics, Tohoku University Graduate School of Dentistry
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de Groot RJ, Merkx MAW, Hamann MNS, Brand HS, de Haan AFJ, Rosenberg AJWP, Speksnijder CM. Tongue function and its influence on masticatory performance in patients treated for oral cancer: a five-year prospective study. Support Care Cancer 2019; 28:1491-1501. [PMID: 31273502 PMCID: PMC6989568 DOI: 10.1007/s00520-019-04913-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/31/2019] [Indexed: 12/20/2022]
Abstract
Purpose The purpose of this study was to observe the impact of oral oncological treatment, including the recovery of several tongue functions (force, mobility, and sensory functions), and to determine the influence of these functions on masticatory performance. Materials and methods Masticatory performance and tongue force, mobility, and sensory functions were determined in 123 patients with oral cavity cancer. The assessments were performed 4 weeks before treatment and 4 to 6 weeks, 6 months, 1 year, and 5 years after treatment. Generalized estimation equations and mixed model analyses were performed, correcting for previously identified factors in the same population. Results A significant deterioration in tongue mobility and sensory function was observed in patients with mandible and tongue and/or floor-of-mouth tumors. Better tongue force and sensory function (thermal and tactile) positively influenced masticatory performance, and this effect was stronger where fewer occlusal units were present. The effect of both the tongue force and maximum bite force was weaker in dentate patients in comparison with patients with full dentures. A web-based application was developed to enable readers to explore our results and provide insight into the coherence between the found factors in the mixed model. Conclusions Tongue function deteriorates after oral oncological treatment, without statistically significant recovery. Adequate bite and tongue forces are especially important for patients with a poor prosthetic state. Patients with sensory tongue function deficits especially benefit from the presence of more occluding pairs.
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Affiliation(s)
- Reilly J de Groot
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Merel N S Hamann
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Henk S Brand
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anton F J de Haan
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands
| | - Caroline M Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands.
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands.
- University Medical Center Utrecht, Cancer Center, Department of Head and Neck Surgical Oncology, Utrecht University, Utrecht, The Netherlands.
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Moore P, Grinsell D, Lyons B, Hewson I. Outcomes of dental and craniofacial osseointegrated implantation in head and neck cancer patients. Head Neck 2019; 41:3290-3298. [DOI: 10.1002/hed.25845] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/11/2019] [Accepted: 06/04/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Phillip Moore
- ENT/Head and Neck UnitSt Vincent's Hospital Melbourne Victoria Australia
| | - Damien Grinsell
- Plastic, Reconstructive, and Hand Surgery UnitSt Vincent's Hospital Melbourne Victoria Australia
| | - Bernard Lyons
- ENT/Head and Neck UnitSt Vincent's Hospital Melbourne Victoria Australia
| | - Ian Hewson
- ENT/Head and Neck UnitSt Vincent's Hospital Melbourne Victoria Australia
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11
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Zweifel D, Bredell MG, Lanzer M, Rostetter C, Rücker M, Studer S. Precision of Simultaneous Guided Dental Implantation in Microvascular Fibular Flap Reconstructions With and Without Additional Guiding Splints. J Oral Maxillofac Surg 2019; 77:971-976. [DOI: 10.1016/j.joms.2018.12.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/27/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
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Petrovic I, Baser R, Blackwell T, McCarthy C, Ganly I, Patel S, Cordeiro P, Shah J. Long-term functional and esthetic outcomes after fibula free flap reconstruction of the mandible. Head Neck 2019; 41:2123-2132. [PMID: 30761650 DOI: 10.1002/hed.25666] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/25/2018] [Accepted: 01/07/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The goal of this study is to report functional and esthetic outcomes, after fibula free flap (FFF) reconstruction of the mandible for oral cancer, assessed by physicians, nonclinicians, and patients. METHODS Twenty-five long-term survivors from oral cancer after FFF reconstruction were recalled for head and neck examination by surgeons, for photographs and patient-reported outcomes, using EORTC, QLQ-C30, H&N35, and FACE-Q questionnaires. RESULTS Physicians reported 64% restoration of functionality compared to normal. Patients reported high scores on QLQ-C30 but lower scores on H&N35. Esthetic scores were reported higher by clinicians than nonclinicians. The decline in function and appearance was attributed to loss of lower dentition, trismus, malocclusion, xerostomia, and tissue atrophy. CONCLUSION To minimize the decline in function and appearance, immediate dental implants in FFF, better reconstruction of the temporomandibular joint, newer methods of radiotherapy to minimize xerostomia and oral exercises to prevent trismus should be considered.
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Affiliation(s)
- Ivana Petrovic
- Dental Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Raymond Baser
- Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Timothy Blackwell
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Colleen McCarthy
- Plastic and Reconstructive Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ian Ganly
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Snehal Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Peter Cordeiro
- Plastic and Reconstructive Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jatin Shah
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.,Memorial Sloan Kettering Cancer Center, and Weil Cornell Medical College, New York.,Department of Oncology and Reconstructive Surgery, I.M. Sechenov First Moscow State Medical University, Moscow
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13
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de Groot RJ, Wetzels JW, Merkx MAW, Rosenberg AJWP, de Haan AFJ, van der Bilt A, Abbink JH, Speksnijder CM. Masticatory function and related factors after oral oncological treatment: A 5-year prospective study. Head Neck 2018; 41:216-224. [PMID: 30552819 PMCID: PMC6590803 DOI: 10.1002/hed.25445] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/18/2018] [Accepted: 07/18/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Chewing ability is often compromised in patients with oral cancer. The aim of this study was to identify which factors affect masticatory performance in these patients. METHODS Patients with primary oral cancer were assessed for up to 5 years after primary treatment. Healthy controls were assessed once. A mixed-model analysis was performed, with masticatory performance as outcome measure. RESULTS A total of 123 patients were included in the study. Factors positively associated with masticatory performance were number of occlusal units (OU), having functional dentures, and maximum mouth opening (MMO). The impact of tumor location and maximum bite force (MBF) differed per assessment moment. Masticatory performance declined for up to 1 year but recovered at 5 years after treatment. CONCLUSION Masticatory performance in patients treated for oral cancer is affected by MBF, MMO, number of OU, and dental status. These should be the focus of posttreatment therapy.
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Affiliation(s)
- Reilly J de Groot
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan-Willem Wetzels
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anton F J de Haan
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andries van der Bilt
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan H Abbink
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Caroline M Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.,Julius Center Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Head and Neck Surgical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
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14
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de Groot RJ, Rosenberg AJWP, van der Bilt A, Aalto D, Merkx MAW, Speksnijder CM. The association between a mixing ability test and patient reported chewing ability in patients treated for oral malignancies. J Oral Rehabil 2018; 46:140-150. [PMID: 30311256 PMCID: PMC7379969 DOI: 10.1111/joor.12734] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 09/03/2018] [Accepted: 10/07/2018] [Indexed: 01/25/2023]
Abstract
Introduction Mastication has been assessed in several ways in the past. Both patients reported and objective assessment methods have been developed. The University Medical Center (UMC) Utrecht has developed a mixing ability test (MAT) using a two‐coloured wax tablet. The present study investigates the association between the mixing ability test and a chewing related questionnaire in patients treated for oral malignancies. Patients and methods In a cohort study, patients treated for oral malignancies were assessed 4‐6 weeks before and 4‐6 weeks after treatment, as well as 6 months, 1 year and 5 years after treatment. The mixing ability test was assessed using 10 and 20 chewing strokes and was compared to seven questions about several aspects of mastication. Regression analysis was performed and density plots were drawn for statistical analysis. Results One hundred and twenty‐three patients were included in this study. The questionnaire was less predictive for the 10‐chewing stroke test and the test was less discriminatory for different food types than the 20‐chewing stroke mixing ability test. Three questions about the ability to chew solid, soft and thickened liquid food types were found to be significantly predictive for the 20‐chewing stroke test. Threshold values on the mixing ability index were around 20 for the ability to chew solid food types and 24 for soft food types. Conclusion The 10‐chewing stroke mixing ability test is less suitable than 20‐chewing strokes for patients with and treated for oral cancer. The 20‐chewing stroke mixing ability test has a fair association with self‐reported outcomes.
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Affiliation(s)
- Reilly J de Groot
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Andries van der Bilt
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Daniel Aalto
- Faculty of Rehabilitation Medicine, Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Alberta, Canada.,Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caroline M Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.,Julius Center Sciences, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.,Department of Head and Neck Surgical Oncology, University Medical Center Utrecht Cancer Center, University Utrecht, Utrecht, The Netherlands
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15
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Engelen M, Buurman DJ, Bronkhorst EM, van Heumen CC. Translation, cross-cultural adaptation, and validation of the Liverpool Oral Rehabilitation Questionnaire (LORQ) into the Dutch language. J Prosthet Dent 2018; 119:239-243. [DOI: 10.1016/j.prosdent.2017.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
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16
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Reissmann DR, Dard M, Lamprecht R, Struppek J, Heydecke G. Oral health-related quality of life in subjects with implant-supported prostheses: A systematic review. J Dent 2017; 65:22-40. [DOI: 10.1016/j.jdent.2017.08.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/09/2017] [Accepted: 08/02/2017] [Indexed: 12/11/2022] Open
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17
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Wetzels JWGH, Meijer GJ, Koole R, Adang EM, Merkx MAW, Speksnijder CM. Costs and clinical outcomes of implant placement during ablative surgery and postponed implant placement in curative oral oncology: a five-year retrospective cohort study. Clin Oral Implants Res 2017; 28:1433-1442. [DOI: 10.1111/clr.13008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Jan-Willem G. H. Wetzels
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
| | - Gert J. Meijer
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
| | - Ron Koole
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
| | - Eddy M. Adang
- Section Biostatistics; Department for Health Evidence; Radboud University Medical Center; Nijmegen The Netherlands
| | - Matthias A. W. Merkx
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
| | - Caroline M. Speksnijder
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
- Julius Center Sciences; University Medical Center Utrecht; Utrecht The Netherlands
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18
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Impact of radiotherapy on implant-based prosthetic rehabilitation in patients with head and neck cancer: A prospective observational study on implant survival and quality of life—Preliminary results. J Craniomaxillofac Surg 2016; 44:1453-62. [DOI: 10.1016/j.jcms.2016.07.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/13/2016] [Accepted: 07/15/2016] [Indexed: 11/19/2022] Open
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19
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Success of dental implants in vascularised fibular osteoseptocutaneous flaps used as onlay grafts after marginal mandibulectomy. Br J Oral Maxillofac Surg 2016; 54:1090-1094. [PMID: 27516164 DOI: 10.1016/j.bjoms.2016.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/10/2016] [Indexed: 11/23/2022]
Abstract
We have evaluated the survival of dental implants placed in vascularised fibular flap onlay grafts placed over marginal mandibulectomies and the effects on marginal bone loss of different types of soft tissue around implants under functional loading. From 2001-2009 we studied a total of 11 patients (1 woman and10 men), three of whom had had ameloblastoma and eight who had had squamous cell carcinomas resected. A total of 38 dental implants were placed either at the time of transfer of the vascularised fibular ostoseptocutaneous flaps (nine patients with 30 implants) or secondarily (two patients with eight implants). Four patients were given palatal mucosal grafts to replace intraoral skin flaps around the dental implants (n=13), and the other seven had the skin flaps around the dental implants thinned (n=25) at the second stage of implantation of the osteointegrated teeth. All vascularised fibular osteoseptocutaneous flaps were successfully transferred, and all implants survived a mean (range) of 73 (33-113) months after occlusal functional loading. The mean (SD) marginal bone loss was 0.5 (0.3) mm on both mesial and distal sides in patients who had palatal mucosal grafts, but 1.8 (1.6) mm, and 1.7 (1.5) mm, respectively, on the mesial and distal sides in the patients who had had thinning of their skin flaps. This difference is significant (p=0.008) with less resorption of bone in the group who had palatal mucosal grafts. Palatal mucosa around the implants helps to reduce resorption of bone after functional loading of implants.
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20
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Implant supported dental rehabilitation following segmental mandibular reconstruction- quality of life outcomes of a prospective randomized trial. J Craniomaxillofac Surg 2016; 44:800-10. [DOI: 10.1016/j.jcms.2016.04.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 03/08/2016] [Accepted: 04/06/2016] [Indexed: 11/24/2022] Open
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21
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Jensen C, Ross J, Feenstra TL, Raghoebar GM, Speksnijder C, Meijer HJA, Cune MS. Cost-effectiveness of implant-supported mandibular removable partial dentures. Clin Oral Implants Res 2016; 28:594-601. [PMID: 27080041 DOI: 10.1111/clr.12840] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. MATERIAL AND METHODS Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP-NL49), a chewing ability test (Mixing Ability Index, MAI) and a short-form health survey measuring perceived general health (SF-36), which was subsequently converted into quality-adjusted-life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was the primary outcome measure of cost-effectiveness, comparing both treatment strategies. RESULTS The mean total opportunity costs were €981 (95% CI €971-€991) for the RPD treatment and €2.480 (95% CI €2.461-€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP-NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. CONCLUSIONS It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost-effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested.
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Affiliation(s)
- Charlotte Jensen
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jamila Ross
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Talitha L Feenstra
- Department of Epidemiology, Health Technology Assessment Unit, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Caroline Speksnijder
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Henny J A Meijer
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marco S Cune
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
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22
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Structured review of papers reporting specific functions in patients with cancer of the head and neck: 2006 - 2013. Br J Oral Maxillofac Surg 2016; 54:e45-51. [PMID: 26923873 DOI: 10.1016/j.bjoms.2016.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 02/09/2016] [Indexed: 11/21/2022]
Abstract
Health-related quality of life (HRQoL) focuses on 4 core domains: physical and psychological function, social interaction, disease, and treatment-related symptoms, and is a key outcome in patients with cancer of the head and neck. We reviewed papers published between 2006 and 2013 that used validated questionnaires to report functional outcome in this group. A total of 572 papers were identified and 118 of them concerned function. Specific outcomes included anxiety, chewing, maxillectomy, mucositis, pain, shoulder function, and trismus. The specific functions most often identified were xerostomia, speech or voice, and swallowing or dysphagia. A considerable body of evidence has now accumulated on HRQoL and functional outomes although the precise role of HRQoL during the planning of treatment remains controversial. Over time, the emphasis of the studies included has tended to move away from the reporting of outcomes in general to more hypothesis-driven and group-specific work.
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23
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Said MM, Otomaru T, Sumita Y, Leung KC, Khan Z, Taniguchi H. Systematic review of literature: functional outcomes of implant-prosthetic treatment in patients with surgical resection for oral cavity tumors. ACTA ACUST UNITED AC 2016; 8. [DOI: 10.1111/jicd.12207] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 11/13/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Mohamed Moustafa Said
- Department of Maxillofacial Prosthetics; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
| | - Takafumi Otomaru
- Department of Maxillofacial Prosthetics; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
| | - Yuka Sumita
- Department of Maxillofacial Prosthetics; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
| | - Katherine C.M. Leung
- Department of Oral Rehabilitation, Faculty of Dentistry; The University of Hong Kong; Hong Kong Hong Kong
| | - Zafrulla Khan
- Maxillofacial/Oncologic Dentistry; James Graham Brown Cancer Center; University of Louisville; Louisville KY USA
| | - Hisashi Taniguchi
- Department of Maxillofacial Prosthetics; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
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24
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Sumida T, Nakano H, Hamakawa H, Mori Y. Dental Implants in Oral Rehabilitation of A Maxillary Cancer Reconstruction: A Case Report. J ORAL IMPLANTOL 2015; 41:737-9. [DOI: 10.1563/aaid-joi-d-13-00136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Tomoki Sumida
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Kyushu University School of Dentistry, Fukuoka, Japan
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hiroyuki Nakano
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Kyushu University School of Dentistry, Fukuoka, Japan
| | - Hiroyuki Hamakawa
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yoshihide Mori
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Kyushu University School of Dentistry, Fukuoka, Japan
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25
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Korfage A, Raghoebar GM, Slater JJH, Roodenburg JL, Witjes MJ, Vissink A, Reintsema H. Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years. Br J Oral Maxillofac Surg 2014; 52:798-805. [DOI: 10.1016/j.bjoms.2014.05.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 05/26/2014] [Indexed: 11/16/2022]
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26
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Korfage A, Raghoebar G, Roodenburg J, Vissink A, Reintsema H. Mandibular implants placed during ablative tumour surgery—which patients can benefit? Int J Oral Maxillofac Surg 2013; 42:1037-9. [DOI: 10.1016/j.ijom.2013.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
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27
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Barrios R, Montero J, González-Moles MA, Baca P, Bravo M. Levels of scientific evidence of the quality of life in patients treated for oral cancer. Med Oral Patol Oral Cir Bucal 2013; 18:e578-84. [PMID: 23722141 PMCID: PMC3731084 DOI: 10.4317/medoral.19052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 02/10/2013] [Indexed: 12/24/2022] Open
Abstract
Treatments used in cancer of the oral cavity have great impact on the physical, psychological and functional state of patients. There has been increasingly interest in evaluating the health-related quality of life using questionnaires among patients treated with oral cancer. Up to our knowledge no review on this theme has incorporated the level of evidence of the single identified studies. The objective of the present study is to determinate results and conclusions about the health-related quality of life of these patients, in view of scientific evidence. In general, the diversity of designs, level of evidence and questionnaires used for their assessment does not affect results, which indicate a decline in the health related quality of life after treatment. This decline is greater when the tumor is large in size, and when radiotherapy is used, though the situation is seen to improve over the span of a year. Questionnaires on health-related quality of life provide concrete information regarding the impact of cancer treatment on patients.
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Affiliation(s)
- Rocío Barrios
- School of Dentistry, University of Granada, Granada, Spain
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28
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Nagy J, Braunitzer G, Antal M, Berkovits C, Novák P, Nagy K. Quality of life in head and neck cancer patients after tumor therapy and subsequent rehabilitation: an exploratory study. Qual Life Res 2013; 23:135-43. [PMID: 23733663 DOI: 10.1007/s11136-013-0446-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study was to evaluate patient-reported quality of life effects of post-treatment intraoral and extraoral rehabilitation in head and neck cancer by repeated measures. METHODS Fifty-nine patients were involved. Basic socio-demographic, oncological and epidemiological data were gathered, and the type of rehabilitation was recorded. For the assessment of quality of life changes, two widely used brief questionnaires, the University of Washington Quality of Life Questionnaire and the Head and Neck module of the European Organization of Research and Treatment for Cancer Quality of Life Questionnaire, were used. The questionnaires were administered to patients two times: the first time after tumor therapy, but before rehabilitation (upon arriving for rehabilitation) and the second time 6 months after the application of any particular method of rehabilitation. Quality of life data were gathered prospectively, while socio-demographic data were gathered from patient files. RESULTS Quality of life after rehabilitation was significantly enhanced as compared to the post-treatment status, in all domains of both questionnaires (p < 0.05 and p < 0.01, Mann-Whitney U). CONCLUSIONS The results support the hypothesis that post-treatment maxillofacial rehabilitation in head and neck cancer does not only restore lost physical capabilities, but also brings about profound changes in patients' quality of life in general.
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Affiliation(s)
- Judit Nagy
- Department of Oral Surgery, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64, 6720, Szeged, Hungary
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29
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Tanaka TI, Chan HL, Tindle DI, Maceachern M, Oh TJ. Updated clinical considerations for dental implant therapy in irradiated head and neck cancer patients. J Prosthodont 2013; 22:432-8. [PMID: 23388045 DOI: 10.1111/jopr.12028] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2012] [Indexed: 11/29/2022] Open
Abstract
An increasing number of reports indicate successful use of dental implants (DI) during oral rehabilitation for head and neck cancer patients undergoing tumor surgery and radiation therapy. Implant-supported dentures are a viable option when patients cannot use conventional dentures due to adverse effects of radiation therapy, including oral dryness or fragile mucosa, in addition to compromised anatomy; however, negative effects of radiation, including osteoradionecrosis, are well documented in the literature, and early loss of implants in irradiated bone has been reported. There is currently no consensus concerning DI safety or clinical guidelines for their use in irradiated head and neck cancer patients. It is important for health care professionals to be aware of the multidimensional risk factors for these patients when planning oral rehabilitation with DIs, and to provide optimal treatment options and maximize the overall treatment outcome. This paper reviews and updates the impact of radiotherapy on DI survival and discusses clinical considerations for DI therapy in irradiated head and neck cancer patients.
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Affiliation(s)
- Takako Imai Tanaka
- Department of Biomedical & Diagnostic Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI, USA.
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30
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Tschiesner U. Preservation of organ function in head and neck cancer. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2012; 11:Doc07. [PMID: 23320059 PMCID: PMC3544204 DOI: 10.3205/cto000089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Preservation of function is a crucial aspect for the evaluation of therapies applied in the field of head and neck cancer. However, preservation of anatomic structures cannot automatically be equated with preservation of function. Functional outcome becomes increasingly important particularly for the evaluation of alternative treatment options with equivalent oncological outcomes.AS A RESULT, PRESENT STUDIES TAKE INTO ACCOUNT THREE TOPIC AREAS WITH VARYING EMPHASIS: (1) the effects of cancer therapy on essential physiological functions, (2) additional therapy-induced side-effects and complications, and (3) health-related quality of life. The present article summarizes vital aspects of clinical research from recent years. Functional outcomes after surgical and non-surgical treatment approaches are presented according to tumor localization and staging criteria. Additional methodological aspects relating to data gathering and documentation as well as challenges in implementing the results in clinical practice are also discussed.
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Affiliation(s)
- Uta Tschiesner
- Clinic for Otorhinolaryngology, Ludwig Maximilians University (LMU) Munich, Munich, Germany
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31
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Caputo JB, Campos SS, Pereira SM, Castelo PM, Gavião MBD, Marques LS, Pereira LJ. Masticatory performance and taste perception in patients submitted to cancer treatment. J Oral Rehabil 2012; 39:905-13. [PMID: 22957850 DOI: 10.1111/joor.12005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2012] [Indexed: 12/28/2022]
Abstract
The aim of this study was to analyse mastication and the sense of taste in 39 patients submitted to cancer treatment in different areas of the body and to compare these variables with those of 44 control individuals within the same age range. The following aspects were assessed: dental status (DMFT); stimulated and non-stimulated salivary flow; sense of taste (salty, sweet, bitter and sour); and masticatory performance (MP), through the calculation of X(50). Logistic regression models were established to test the association between the independent variables and cancer treatment. Cancer patients had lesser stimulated salivary flow, a smaller number of teeth and occlusal units, worse MP, higher salty, sweet and sour taste scores and a lower bitter taste score (P < 0·05). A significant positive correlation was found between MP and the DMFT index in both groups (P < 0·05), meaning that a lower DMFT index value denoted a smaller X(50) value (better masticatory performance). The logistic regression model revealed that patients who had undergone cancer treatment had a greater probability of exhibiting a smaller number of teeth, higher salty and smaller bitter taste scores (P < 0·05). It was concluded that patients who were submitted to cancer treatment presented oral physiology alterations when compared with control subjects at the same age range.
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Affiliation(s)
- J B Caputo
- Centro Universitário de Lavras, Lavras, Brazil
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32
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Mitchell O, Durrani A, Price R. Rehabilitation of patients following major head and neck cancer surgery. ACTA ACUST UNITED AC 2012; 21:S31-7. [DOI: 10.12968/bjon.2012.21.sup10.s31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Amer Durrani
- Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge
| | - Richard Price
- Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge
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33
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34
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Macfarlane TV, Wirth T, Ranasinghe S, Ah-See KW, Renny N, Hurman D. Head and neck cancer pain: systematic review of prevalence and associated factors. J Oral Maxillofac Res 2012; 3:e1. [PMID: 24422003 PMCID: PMC3886092 DOI: 10.5037/jomr.2012.3101] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 02/23/2012] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Pain is a major symptom in patients with cancer; however information on head and neck cancer related pain is limited. The aim of this review was to investigate the prevalence of pain and associated factors among patients with HNC. MATERIAL AND METHODS The systematic review used search of MEDLINE, EMBASE and CINAHL databases to December 2011. Cancers of the oral mucosa, oropharynx, hypopharynx and larynx were included in this review with pain as main outcome. The review was restricted to full research reports of observational studies published in English. A checklist was used to assess the quality of selected studies. RESULTS There were 82 studies included in the review and most of them (84%) were conducted in the past ten years. Studies were relatively small, with a median of 80 patients (IQR 44, 154). The quality of reporting was variable. Most studies (77%) used self-administered quality of life questionnaires, where pain was a component of the overall scale. Only 33 studies reported pain prevalence in HNC patients (combined estimate from meta-analysis before (57%, 95% CI 43% - 70%) and after (42%, 95% CI 33% - 50%) treatment. Only 49 studies (60%) considered associated factors, mostly tumour- or treatment-related. CONCLUSIONS The study has shown high levels of pain prevalence and some factors associated with higher levels of pain. There is a need for higher quality studies in a priority area for the care of patients with head and neck cancer.
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Affiliation(s)
| | - Tanja Wirth
- School of Medicine and Dentistry, University of Aberdeen, AberdeenUnited Kingdom.
- University of Bremen, BremenGermany.
| | - Sriyani Ranasinghe
- School of Medicine and Dentistry, University of Aberdeen, AberdeenUnited Kingdom.
- Postgraduate Institute of Medicine, University of ColomboSri Lanka.
| | - Kim W. Ah-See
- Department of Otolaryngology, Aberdeen Royal Infirmary, AberdeenUnited Kingdom.
| | - Nick Renny
- Department of Maxillofacial Surgery, Aberdeen Royal Infirmary, AberdeenUnited Kingdom.
| | - David Hurman
- Department of Clinical Oncology, Aberdeen Royal Infirmary, AberdeenUnited Kingdom.
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