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Fleissig Y, Casap N, Abu-Tair J, Fernandes RP. Long-Term Survival of Dental Implants in Irradiated Patients. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00056-6. [PMID: 39266367 DOI: 10.1016/j.coms.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
The surgical ablation of head and neck cancer followed by radiotherapy often leads to unfavorable functional and aesthetic outcomes. Studies have demonstrated that these outcomes can significantly impact quality of life. Dental implants play a crucial role in rehabilitation by facilitating the use of suprastructures and obturators. However, the long-term survival of dental implants in patients who have undergone radiotherapy remains uncertain, raising several questions. These include determining the optimal timing for dental implantation (before or after radiotherapy), identifying the radiotherapy threshold for implant loss, and considering the role of hyperbaric oxygen therapy. These and other related concerns will be addressed in the following article.
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Affiliation(s)
- Yoram Fleissig
- Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel; Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel.
| | - Nardy Casap
- Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel; Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Jawad Abu-Tair
- Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel; Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Rui P Fernandes
- Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine - Jacksonville, 653-1 West 8th, Street, Jacksonville, FL 32209, USA
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Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, Tavahodi N, Namanloo RA, Heboyan A, Fathi A. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil 2024; 51:1250-1302. [PMID: 38570927 DOI: 10.1111/joor.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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Affiliation(s)
- Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
| | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Hamid Reza Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Mohammad Darvishi
- Faculty of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Camolesi GCV, Veronese HRM, Celestino MA, Blum DFC, Márquez-Zambrano JA, Carmona-Pérez FA, Jara-Venegas TA, Pellizzon ACA, Bernaola-Paredes WE. Survival of osseointegrated implants in head and neck cancer patients submitted to multimodal treatment: a systematic review and meta-analysis. Support Care Cancer 2023; 31:641. [PMID: 37851170 DOI: 10.1007/s00520-023-08088-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on the consequences of the main complications, such as osteoradionecrosis and peri-implantitis. METHODS An electronic search conducted by PRISMA protocol was performed. Full texts were carefully assessed, and data were assimilated into a tabular form for discussion and consensus among the expert panel. The quality assessment and the risk of bias are verified by Joanna Briggs Institute checklist (JBI) and The Newcastle-Ottawa Scale (NOS), and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) assessment tool. RESULTS A total of 452 records were identified in the based on our PICOs strategy and after screening, 19 articles were included in the descriptive analysis of the review. Totaling 473 implants placed in irradiated and non-irradiated bone, and 31.6% of the patients were over 60 years of age. 57.9%) performed implant placement in a period of 12 months or more after the ending of radiotherapy. Only 5 studies had a follow-up period longer than 5 years after implant placement, of which three were used for the meta-analysis. In the meta-analysis of 5-year survival rate, analysis of implants in irradiated bone was assessed; a random effect model was used and a weighted proportion (PP) of 93.13% (95% CI: 87.20-99.06; p < 0.001), and in the 5-year survival rate, analysis of implants in non-irradiated bone was analysed; a fixed effect model was used and a weighted proportion (PP) of 98.52% survival (95% CI: 97.56-99.48, p < 0.001). CONCLUSIONS Survival rates of implants placed in irradiated bone are clinically satisfactory after a follow-up of 5 years, with a fewer percentage than in implants placed in non-irradiated bone after metanalyses performed.
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Affiliation(s)
- Gisela Cristina Vianna Camolesi
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782, Santiago de Compostela, Spain.
| | | | | | - Davi Francisco Casa Blum
- Department of Oral and Maxillofacial Surgery, Atitus Education, Passo Fundo, Rio Grande Do Sul, Brazil
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Brauner E, Piccoli L, Sallemi K, Romeo U, Laudoni F, Cantore M, Tenore G, Pranno N, De Angelis F, Di Cosola M, Valentini V, Di Carlo S. Evaluation of a Novel Technique for Closure of Small Palatal Fistula. J Pers Med 2022; 13:jpm13010065. [PMID: 36675726 PMCID: PMC9861307 DOI: 10.3390/jpm13010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/04/2022] [Accepted: 12/16/2022] [Indexed: 12/29/2022] Open
Abstract
A palatal fistula is a pathological condition that connects the nasal cavities with the oral cavity. An oral-nasal fistula is reported as a possible post-surgical complication after the removal of oral carcinomas. The presence of a palatal fistula affects the patient's quality of life, making it necessary to apply a prosthetic device, such as a palatal plate, to keep the nasal cavities separated from the oral one. There are several surgical techniques to close a palatal fistula, but it is not possible to define the optimal technique as the approach is extremely dependent on the characteristics of the fistula. The aim of this article is to propose a minimally invasive technique to reduce the size of palatal fistulae and to reduce the surgical difficulty (NSPF). A total of 20 patients fulfilled the inclusion criteria and were checked every two weeks. The fistula was injured with a needle every 2 weeks. Fifteen patients who healed with complete closure of the fistula reported no need for a palatal protection plate to eat, drink and speak normally. It is possible to conclude that the NSPF protocol is a valid approach for the non-surgical reduction of palatal fistulae, and it is possible, when the appropriate conditions are present, to achieve complete closure.
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Affiliation(s)
- Edoardo Brauner
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Implanto-Prosthetic, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Luca Piccoli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Implanto-Prosthetic, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Karim Sallemi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Correspondence:
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Federico Laudoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Marco Cantore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Francesca De Angelis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00167 Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Implanto-Prosthetic, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
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Schiegnitz E, Reinicke K, Sagheb K, König J, Al-Nawas B, Grötz KA. Dental implants in patients with head and neck cancer-A systematic review and meta-analysis of the influence of radiotherapy on implant survival. Clin Oral Implants Res 2022; 33:967-999. [PMID: 35841367 DOI: 10.1111/clr.13976] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/23/2022] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this meta-analysis was to compare implant survival in irradiated and non-irradiated bone and to investigate potential risk factors for implant therapy in oral cancer patients. MATERIAL AND METHODS An extensive search in the electronic databases of the National Library of Medicine was performed. Systematic review and meta-analysis were conducted according to PRISMA statement. The meta-analysis was performed for studies with a mean follow-up of at least three and five years, respectively. RESULTS The systematic review resulted in a mean overall implant survival of 87.8% (34%-100%). The meta-analysis revealed a significantly higher rate of implant failure in irradiated bone compared to non-irradiated bone (p < .00001, OR 1.97, CI [1.63, 2.37]). The studies also showed that implants placed into irradiated grafted bone were more likely to fail than those in irradiated native bone (p < .0001, OR 2.26, CI [1.50, 3.40]). CONCLUSION Even though overall implant survival was high, radiotherapy proves to be a significant risk factor for implant loss. Augmentation procedures may also increase the risk of an adverse outcome, especially in combination with radiotherapy. CLINICAL RELEVANCE The treatment of patients receiving radiotherapy of any form requires precise individual planning and a close aftercare. Implants should be placed in local bone rather than in bone grafts, if possible.
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Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany
| | - Katrin Reinicke
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany
| | - Knut A Grötz
- Department of Oral and Maxillofacial Surgery, Dr. Horst Schmidt Clinic Wiesbaden, Wiesbaden, Germany
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Brauner E, Valentini V, Romeo U, Cantore M, Laudoni F, Rajabtork Zadeh O, Formisano V, Cassoni A, Della Monaca M, Battisti A, Mezi S, Cirillo A, De Felice F, Botticelli A, Tombolini V, De Vincentiis M, Colizza A, Tenore G, Polimeni A, Di Carlo S. Dental Implant Failure Risk in Post Oncological Patients, a Retrospective Study and Sapienza Head and Neck Unit Decisional Protocol- 7 Years of Follow-Up. Diagnostics (Basel) 2022; 12:diagnostics12081863. [PMID: 36010214 PMCID: PMC9406984 DOI: 10.3390/diagnostics12081863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Patients with head and neck cancer are treated by ablative surgery, radiotherapy, chemotherapy, or a combination of these. The side effects of cancer therapies can compromise conventional prosthesis rehabilitation; therefore, dental implants can result in a more effective solution. The aim of the study is to explain how to rehabilitate a patient that underwent head and neck cancer therapy. (2) Methods: This retrospective study conducted from 2015 to 2021 included 223 postoncological patients, aged between 32 and 80 years old. Eighteen patients did not proceed with any treatment, and two died. Therefore, 203 patients have been analyzed and rehabilitated following our decisional protocol, with a mean period of follow-up of 4 years. The implant placement was considered successful when a mean bone loss of 1.6 mm for the first year and a mean of 0.13 mm in subsequent years occurred (3) Results: A total of 161 patients were rehabilitated with a conventional prosthesis, 42 patients (F:M ratio 19:23) with an implant-supported prosthesis and a total of 200 implants were placed; 9 implants were lost (4.5% of 200 implants). Conclusions: The results confirmed that by following our protocol it is possible to obtain an acceptable rate of implant survival, considering the delicacy and complexity of post-oncological patients.
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Affiliation(s)
- Edoardo Brauner
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Marco Cantore
- Independent Researcher, Corso Italia 19, 58015 Orbetello, Italy
- Correspondence:
| | - Federico Laudoni
- Independent Researcher, via Garibaldi 141, 00012 Guidonia, Italy;
| | - Oriana Rajabtork Zadeh
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | | | - Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Marco Della Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Andrea Battisti
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Silvia Mezi
- Department of Radiological Oncological and Pathological Science, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.C.); (F.D.F.); (A.B.); (V.T.)
| | - Alessio Cirillo
- Department of Radiological Oncological and Pathological Science, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.C.); (F.D.F.); (A.B.); (V.T.)
| | - Francesca De Felice
- Department of Radiological Oncological and Pathological Science, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.C.); (F.D.F.); (A.B.); (V.T.)
| | - Andrea Botticelli
- Department of Radiological Oncological and Pathological Science, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.C.); (F.D.F.); (A.B.); (V.T.)
| | - Vincenzo Tombolini
- Department of Radiological Oncological and Pathological Science, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.C.); (F.D.F.); (A.B.); (V.T.)
| | - Marco De Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Andrea Colizza
- Department of Sense Organs, Policlinico Umberto 1 Sapienza University of Rome, viale Regina Elena 326, 00161 Roma, Italy;
| | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (V.V.); (U.R.); (O.R.Z.); (A.C.); (M.D.M.); (A.B.); (M.D.V.); (G.T.); (A.P.); (S.D.C.)
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Brauner E, Laudoni F, Amelina G, Cantore M, Armida M, Bellizzi A, Pranno N, De Angelis F, Valentini V, Di Carlo S. Dental Management of Maxillofacial Ballistic Trauma. J Pers Med 2022; 12:jpm12060934. [PMID: 35743719 PMCID: PMC9225066 DOI: 10.3390/jpm12060934] [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: 04/28/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Maxillofacial ballistic trauma represents a devastating functional and aesthetic trauma. The extensive damage to soft and hard tissue is unpredictable, and because of the diversity and the complexity of these traumas, a systematic algorithm is essential. This study attempts to define the best management of maxillofacial ballistic injuries and to describe a standardized, surgical and prosthetic rehabilitation protocol from the first emergency stage up until the complete aesthetic and functional rehabilitation. In low-velocity ballistic injuries (bullet speed <600 m/s), the wound is usually less severe and not-fatal, and the management should be based on early and definitive surgery associated with reconstruction, followed by oral rehabilitation. High-velocity ballistic injuries (bullet speed >600 m/s) are associated with an extensive hard and soft tissue disruption, and the management should be based on a three-stage reconstructive algorithm: debridement and fixation, reconstruction, and final revision. Rehabilitating a patient with ballistic trauma is a multi-step challenging treatment procedure that requires a long time and a multidisciplinary team to ensure successful results. The prosthodontic treatment outcome is one of the most important parameters by which a patient measures the restoration of aesthetic, functional, and psychological deficits. This study is a retrospective review: twenty-two patients diagnosed with outcomes of ballistic traumas were identified from the department database, and eleven patients met the inclusion criteria and were enrolled.
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Affiliation(s)
- Edoardo Brauner
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Federico Laudoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Giulia Amelina
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Correspondence:
| | - Marco Cantore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Matteo Armida
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Andrea Bellizzi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Francesca De Angelis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00167 Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
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Wolf F, Spoerl S, Gottsauner M, Klingelhöffer C, Spanier G, Kolbeck C, Reichert TE, Hautmann MG, Ettl T. Significance of site-specific radiation dose and technique for success of implant-based prosthetic rehabilitation in irradiated head and neck cancer patients-A cohort study. Clin Implant Dent Relat Res 2021; 23:444-455. [PMID: 33949108 DOI: 10.1111/cid.13005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/29/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Radiotherapy aggravates implant-based prosthetic rehabilitation in patients with head and neck cancer. PURPOSE To evaluate the impact of radiation dose at implant and parotid gland site for prosthetic rehabilitation. MATERIAL AND METHODS The retrospective study includes 121 irradiated head and neck cancer patients with 751 inserted implants. Radiation doses on implant bed and parotid gland site were recorded by 3-dimensional modulated radiation plans. Implant success was clinically and radiographically evaluated according to modified Albrektsson criteria and compared to treatment- and patient-specific data. RESULTS Implant overall survival after 5 years was 92.4% with an implant success rate of 74.9%. Main reasons for implant failure were marginal bone resorption (20.9%), implant not in situ or unloaded (9.6%) and peri-implantitis (7.5%). A mean radiation dose of 62.6 Gy was applied with a mean parotid dose of 35 Gy. Modulating radiation techniques went along with lower grades of xerostomia (p < 0.001). At implant site mean doses of 57.5, 42.0, and 32.3 Gy were recorded for oral, oropharyngeal, and hypopharyngeal/laryngeal carcinoma, respectively. Implant success inversely correlated to radiation dose at implant site. Strong predictors for implant failure in uni- and multivariate analysis were implant-specific dose >50 Gy (HR 7.9), parotid dose >30 Gy (HR 2.3), bone (HR 14.5) and soft tissue (HR 4.5) transplants, bad oral hygiene (HR 3.8), nonmodulated radiation treatment planning (HR 14.5), and nontelescopic prosthetics (HR 5.2). CONCLUSION Radiotherapy impedes implant success in a dose-dependent manner at implant site. Modern radiation techniques effectively reduce xerostomia favoring implant-based prosthetic rehabilitation. Implantation in bone grafts is more critical and telescopic-retained overdentures should be preferred.
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Affiliation(s)
- Franziska Wolf
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Steffen Spoerl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Maximilian Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Christoph Klingelhöffer
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Gerrit Spanier
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Carola Kolbeck
- Department of Prosthodontics, University Hospital Regensburg, Regensburg, Germany
| | - Torsten E Reichert
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Matthias G Hautmann
- Department of Radiotherapy, University Hospital Regensburg, Regensburg, Germany
| | - Tobias Ettl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
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9
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Brauner E, Mezi S, Ciolfi A, Ciolfi C, Pucci R, Cassoni A, Battisti A, Piesco G, De Felice F, Pranno N, Armida M, De Angelis F, Romeo U, Capocci M, Tenore G, Tombolini V, Valentini V, Ottolenghi L, Polimeni A, Di Carlo S. A New Medical Record Proposal to the Prognostic Risk Assessment for MRONJ in Oncologic Patients: "Sapienza Head and Neck Unit" Proposal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041851. [PMID: 33672876 PMCID: PMC7918934 DOI: 10.3390/ijerph18041851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event associated with antiresorptive and antiangiogenic drugs. The use of these drugs in the treatment of cancer patients with bone metastasis is necessary and standardized in the literature. A multidisciplinary approach for the patient’s management is strongly recommended. Therefore, it should be necessary to integrate the path of these subjects with a dedicated dental screening in order to first assess the individual risk of developing a MRONJ, and then to plan dental treatments and oral hygiene sessions, and finally to schedule a follow-up to intercept and treat early osteonecrosis. The aim of this manuscript is to propose a new simple medical report to evaluate patients affected by metastatic bone cancer in order to reduce the risk of developing MRONJ.
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Affiliation(s)
- Edoardo Brauner
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Silvia Mezi
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Alessandro Ciolfi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
- Correspondence: ; Tel.: +39-3397737410
| | - Chiara Ciolfi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Resi Pucci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Andrea Cassoni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Andrea Battisti
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Gabriele Piesco
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Francesca De Felice
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Nicola Pranno
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Matteo Armida
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Francesca De Angelis
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Umberto Romeo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Mauro Capocci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Gianluca Tenore
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Vincenzo Tombolini
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Valentino Valentini
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Livia Ottolenghi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Stefano Di Carlo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
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10
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Neckel N, Wagendorf P, Sachse C, Stromberger C, Vach K, Heiland M, Nahles S. Influence of implant-specific radiation doses on peri-implant hard and soft tissue: An observational pilot study. Clin Oral Implants Res 2020; 32:249-261. [PMID: 33278849 DOI: 10.1111/clr.13696] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the influence of real implant-bed-specific radiation doses on peri-implant tissue health in head and neck cancer (HNC) patients after radiotherapy. MATERIAL AND METHODS Specific radiation doses in the area of 81 implants, in 15 irradiated HNC patients, were analyzed by matching data from the radiotherapy planning system with those of three-dimensional follow-up scans after implantation. Peri-implant bone resorption was measured radiographically after 1 and 3 years, and peri-implant tissue health was evaluated clinically. Individual parameters, such as age, gender, and localization, regarding the implant-specific radiation dose distribution were analyzed statistically. RESULTS The mean implant-bed-specific radiation dose was high, with 45.95 Gy to the mandible and 29.02 Gy to the maxilla, but significantly lower than the mean total dose to the tumor bed. Peri-implant bone resorption correlated with local inflammation and plaque. After 1 year, women temporarily showed significantly more bone loss than men and implant-specific radiation dose had a significant impact on peri-implant bone loss after 3 years. CONCLUSIONS The presented method is a feasible option to define precise implant-bed-specific radiation doses for research or treatment planning purposes. Implant-based dental restoration after radiotherapy is a relatively safe procedure, but a negative radiation dose-dependent long-term effect on peri-implant bone resorption calls for interdisciplinary cooperation between surgeons and radio-oncologists to define high-risk areas.
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Affiliation(s)
- Norbert Neckel
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Pia Wagendorf
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Claudia Sachse
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Carmen Stromberger
- Department of Radiation Oncology and Radiotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Medical Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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11
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Cassoni A, Brauner E, Pucci R, Terenzi V, Mangini N, Battisti A, Della Monaca M, Ciolfi A, Laudoni F, Di Carlo S, Valentini V. Head and Neck Osteosarcoma-The Ongoing Challenge about Reconstruction and Dental Rehabilitation. Cancers (Basel) 2020; 12:cancers12071948. [PMID: 32708374 PMCID: PMC7409227 DOI: 10.3390/cancers12071948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/27/2022] Open
Abstract
Head and Neck osteosarcoma is an uncommon disease. Hitherto, the treatment is surgical resection and survival is influenced by the presence of free margins. However, the dimension of the resection may represent a hurdle for an adequate Quality of Life (QOL). Maxillofacial district is a narrow space where the function, esthetics and patient’s relational skills fit together like the gears of a clock. The functional results depend on the type of reconstruction and prosthetic rehabilitation that are both important to guarantee a good aesthetic result and finally increase the patient’s self-esteem. This study aims to report our experience about head and neck (HN) osteosarcoma focusing the attention on reconstructive and dental-rehabilitative problems. It is a retrospective study all patients were surgically treated in our department. Subjects with histological diagnosis of HN osteosarcoma, treated between 2005 and 2017 were included. The demographic characteristics, surgical treatment, eventually secondary reconstruction and prosthetic rehabilitation, performed in the same department, have been collected. The QOL was assessed through the EORTC QLQ-H&N35 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35) questionnaire. Fifteen patients were enrolled, eight received a free flap microsurgical reconstruction. Dental rehabilitation was performed in five cases and a mobile prosthesis was always delivered. Eighteen implants were inserted in fibula bones for three patients; highly porous implants were used.
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Affiliation(s)
- Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Oncological and Reconstructive Maxillo—Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy;
| | - Edoardo Brauner
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Correspondence: ; Tel.: +6-499-791-46; Fax: +6-499-791-49
| | - Valentina Terenzi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Nicolò Mangini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Andrea Battisti
- Oncological and Reconstructive Maxillo—Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy;
| | - Marco Della Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Alessandro Ciolfi
- Private Practice, Studio Dentistico Ciolfi, via degli Elci 39, 00172 Rome, Italy;
| | - Federico Laudoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Oncological and Reconstructive Maxillo—Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy;
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12
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Attitude in Radiographic Post-Operative Assessment of Dental Implants among Italian Dentists: A Cross-Sectional Survey. Antibiotics (Basel) 2020; 9:antibiotics9050234. [PMID: 32392719 PMCID: PMC7277755 DOI: 10.3390/antibiotics9050234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/24/2020] [Accepted: 05/06/2020] [Indexed: 12/13/2022] Open
Abstract
There is a lack of evidence in the attitude and prescribing practice of implantologists in dental implant post-operative assessment; therefore, the aims of this cross-sectional study were to investigate these habits and the knowledge about radiographic aspect of retrograde peri-implantitis (RPI) among Italian implantologists. A questionnaire was sent via email to dentists randomly selected from the register of implantology and oral surgery societies. It included three questions: the preferred X-ray after implant placement, the timing of post-operative assessment and the knowledge of the RPI radiographic representation. A final sample of 434 implantologists was included in the study. The majority of them (84.3%) perform a periapical X-ray as control radiograph and picked the correct radiographic representation of RPI (74.3%), without statistically significant differences (p > 0.05) for sex, age, years of working practice and number of implants placed per year. Just 47.7% of dentists perform a control radiograph at prostheses delivery, to establish a proper baseline. A statistically significant difference (p < 0.05) was detectable only for the number of implants placed per year, with dentists placing > 80 implants selecting the correct choice. To the best of authors’ knowledge, this is the first study to report data on attitude of implantologists in radiographic imaging after implant placement.
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Wiedenmann F, Liebermann A, Probst F, Troeltzsch M, Balermpas P, Guckenberger M, Edelhoff D, Mayinger M. A pattern of care analysis: Prosthetic rehabilitation of head and neck cancer patients after radiotherapy. Clin Implant Dent Relat Res 2020; 22:333-341. [DOI: 10.1111/cid.12912] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/19/2020] [Accepted: 03/31/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Felicitas Wiedenmann
- Department of Prosthetic Dentistry University Hospital, LMU Munich Munich Germany
| | - Anja Liebermann
- Department of Prosthetic Dentistry University Hospital, LMU Munich Munich Germany
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery University Hospital, LMU Munich Munich Germany
| | - Matthias Troeltzsch
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery University Hospital, LMU Munich Munich Germany
| | - Panagiotis Balermpas
- Department of Radiation Oncology University Hospital Zurich, University of Zurich Zurich Switzerland
| | - Matthias Guckenberger
- Department of Radiation Oncology University Hospital Zurich, University of Zurich Zurich Switzerland
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry University Hospital, LMU Munich Munich Germany
| | - Michael Mayinger
- Department of Radiation Oncology University Hospital Zurich, University of Zurich Zurich Switzerland
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14
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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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