1
|
Marques NP, Pérez-de-Oliveira ME, Normando AGC, Marques NCT, Epstein JB, Migliorati CA, Martelli-Júnior H, Ribeiro ACP, Rocha AC, Brandão TB, Sánchez FGV, Gueiros LAM, Lopes MA, Santos-Silva AR. Clinical outcomes of dental implants in head and neck cancer patients: An overview. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:42-53. [PMID: 36890080 DOI: 10.1016/j.oooo.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/03/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical outcomes of dental implants (DIs) in patients with head and neck cancer (HNC) treated with radiotherapy (RT), isolated chemotherapy, or bone modifying agents (BMAs). STUDY DESIGN This study was registered in the Prospective Register of Systematic Reviews (CRD42018102772); conducted via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; and based on PubMed, Scopus, Embase, Cochrane Library, Web of Science, and gray literature searches. The selection of studies was performed in 2 phases by 2 independent reviewers. The risk of bias (RoB) was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2. RESULTS Twenty systematic reviews were included in the qualitative analysis. The majority scored as having high RoB (n = 11). Primary DIs placement in the mandible of patients with HNC subjected to RT doses <50 Gy was associated with better survival rates. CONCLUSIONS The placements of DIs could be considered safe in patients with HNC in sites of alveolar bone that received RT (≤5000 Gy); however, no conclusions could be made in patients with cancer managed by chemotherapy or BMAs. Due to the heterogeneity of studies included, the recommendation for DIs placement in patients with cancer should be carefully considered. Future better controlled randomized clinical trials are required to provide enhanced clinical guidelines for best patient care.
Collapse
Affiliation(s)
- Nelson Pereira Marques
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Dental School, University Center of Lavras, Lavras, Minas Gerais, Brazil.
| | - Maria Eduarda Pérez-de-Oliveira
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Ana Gabriela Costa Normando
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Nádia Carolina Teixeira Marques
- Dental School, University Center of Lavras, Lavras, Minas Gerais, Brazil; School of Nursing and Pharmacy, University Center of Lavras, Lavras, Minas Gerais, Brazil
| | - Joel B Epstein
- Oral Medicine Services, CA City of Hope National Medical Center, Duarte, CA, USA
| | - Cesar A Migliorati
- Department of Oral & Maxillofacial Diagnostic Sciences, University of Florida, Gainesville, FL, USA
| | - Hercílio Martelli-Júnior
- School of Nursing and Pharmacy, University Center of Lavras, Lavras, Minas Gerais, Brazil; Primary Care Postgraduate Program, State University of Montes Claros Unimontes, Montes Claros, Minas Gerais, Brazil
| | | | - Andre Caroli Rocha
- Divisão de Odontologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Thaís Bianca Brandão
- Serviço de Odontologia Oncológica, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | - Luiz Alcino Monteiro Gueiros
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| |
Collapse
|
2
|
Radiotherapy and the survival of dental implants: a systematic review. Br J Oral Maxillofac Surg 2021; 60:422-429. [PMID: 34903387 DOI: 10.1016/j.bjoms.2021.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/05/2021] [Indexed: 12/24/2022]
Abstract
For patients with head and neck cancer, the effects of treatment with adjuvant radiotherapy can be devastating. Frequently there is loss of function due to tooth loss, pain and discomfort from xerostomia and mucositis, and a significant psychosocial impact. Dental implants provide an effective means of rehabilitation for many, but irradiation poses a unique set of challenges that can affect the outcome of treatment. The aims of this review were to find out whether radiotherapy in these patients affects the survival of dental implants, and to discuss details of pertinent influencing factors. An electronic search of the Medline, Web of Science, and CENTRAL databases was done to identify studies on the survival of implants in irradiated patients within specified inclusion and exclusion criteria. No restriction was placed on the year of publication. The primary outcome measure was implant survival. Seven studies involving 441 participants and 1502 implants placed into irradiated bone were included. Meta-analysis indicated that survival was significantly higher in the mandible compared with the maxilla (p = 0.04), and in non-irradiated cases compared with irradiated cases (p < 0.001). Other factors that showed a strong association with survival were radiation dose and timing of surgery. Implant-based rehabilitation is a viable option for head and neck cancer patients who have undergone radiotherapy. Whilst the short to medium-term implant survival in these cases is high, multiple factors require careful consideration for a favourable outcome. Further high-quality research and randomised controlled trials are required in this field.
Collapse
|
3
|
Harman RM, Das SP, Bartlett AP, Rauner G, Donahue LR, Van de Walle GR. Beyond tradition and convention: benefits of non-traditional model organisms in cancer research. Cancer Metastasis Rev 2020; 40:47-69. [PMID: 33111160 DOI: 10.1007/s10555-020-09930-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023]
Abstract
Traditional laboratory model organisms are indispensable for cancer research and have provided insight into numerous mechanisms that contribute to cancer development and progression in humans. However, these models do have some limitations, most notably related to successful drug translation, because traditional model organisms are often short-lived, small-bodied, genetically homogeneous, often immunocompromised, are not exposed to natural environments shared with humans, and usually do not develop cancer spontaneously. We propose that assimilating information from a variety of long-lived, large, genetically diverse, and immunocompetent species that live in natural environments and do develop cancer spontaneously (or do not develop cancer at all) will lead to a more comprehensive understanding of human cancers. These non-traditional model organisms can also serve as sentinels for environmental risk factors that contribute to human cancers. Ultimately, expanding the range of animal models that can be used to study cancer will lead to improved insights into cancer development, progression and metastasis, tumor microenvironment, as well as improved therapies and diagnostics, and will consequently reduce the negative impacts of the wide variety of cancers afflicting humans overall.
Collapse
Affiliation(s)
- Rebecca M Harman
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Sanjna P Das
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Arianna P Bartlett
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Gat Rauner
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Leanne R Donahue
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Gerlinde R Van de Walle
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA.
| |
Collapse
|
4
|
Rouers M, Bornert F, Truntzer P, Dubourg S, Bourrier C, Antoni D, Noël G. Ability to Propose Optimal Prosthetic Rehabilitation can be Improved by Discussion between the Dentist and Radiation Oncologist Regarding Upstream Dosimetry. Eur J Dent 2019; 13:88-94. [PMID: 31170766 PMCID: PMC6635961 DOI: 10.1055/s-0039-1688523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective
Improvement of dental rehabilitation for patients who have undergone radiation therapy requires knowledge of the dose in the maxillary and mandible bones.
Materials and Methods
Forty-three patients with head and neck cancers underwent evaluation for dental rehabilitation before radiation treatment dosimetry. The delivered dose to the maxilla and mandible was determined. From the dose data in the literature, three levels of risk of implant failure were defined. According to the delivered doses, the authors calculated the percentage of patients who could be fully rehabilitated with an implant, as proposed by the dentist before radiation planning.
Results
Before dosimetry calculation, all of the completely edentulous arches and 94 partially edentulous (PESs) sextants could be optimally rehabilitated. After dose calculation, among the 14 arches of 7 patients who were completely edentulous, according to the mean and maximal delivered doses, 11 arches (78.6%) and 7 arches (50%) could receive an optimal prosthesis, respectively. For the three patients, who were PESs but with one arch that was completely edentulous, according to the mean and maximal delivered doses, one arch for each dose condition could receive an optimal prosthesis. Among the 94 PESs sextants, according to the mean and maximal delivered doses, 41 (43.6%) and 24 (25.5%) sextants could receive an optimal prosthesis, respectively.
Conclusion
By determining the sites of implantation before dosimetry, the radiation oncologist could shield specified areas, potentially improving the possibilities for dental rehabilitation. The dialogue between the dentist and the radiation oncologist can improve the possibilities for implants and decrease the risk of unsafe implantation.
Collapse
Affiliation(s)
- Mélanie Rouers
- Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France
| | - Fabien Bornert
- Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France
| | - Pierre Truntzer
- University Radiation Department, Centre Paul Strauss, Strasbourg, France
| | - Sarah Dubourg
- Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France
| | - Cyrielle Bourrier
- University Radiation Department, Centre Paul Strauss, Strasbourg, France
| | - Delphine Antoni
- University Radiation Department, Centre Paul Strauss, Strasbourg, France.,Strasbourg University, Radiobiology Lab, Centre Paul Strauss, Strasbourg, France
| | - Georges Noël
- University Radiation Department, Centre Paul Strauss, Strasbourg, France.,Strasbourg University, Radiobiology Lab, Centre Paul Strauss, Strasbourg, France
| |
Collapse
|
5
|
Combination Use of BMP2 and VEGF165 Promotes Osseointegration and Stability of Titanium Implants in Irradiated Bone. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8139424. [PMID: 30627574 PMCID: PMC6304532 DOI: 10.1155/2018/8139424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/14/2018] [Accepted: 11/14/2018] [Indexed: 02/05/2023]
Abstract
Background Clinical data demonstrated that failure rate of titanium implant in irradiated bone was 2-3 times higher than that in nonirradiated bone and it is difficult to get the ideal results in irradiated bone. Purpose The aim of the study was to investigate the effects of HBO, BMP2, VEGF165, and combined use of BMP2/VEGF165 on osseointegration and stability of titanium implant in irradiated bone. Materials and Methods Sixty rabbits were randomly assigned to 5 groups (control group, HBO group, VEGF165 group, BMP2 group, and BMP2/VEGF165 group) after receiving 15 Gy radiation. Implant surgery was performed on tibias eight weeks later. They were sacrificed at two or eight weeks after operation. Implant stability, calcium, and ALP activity in serum, the ratio of bone volume to total volume, the rate of bone growth, and gene expression were assessed. Result There was no mortality and no implants failed during the experiment. Implant stability was significantly compromised in the control group compared to the other four experimental groups, and the BMP2/VEGF165 group had the highest implant stability. HBO, BMP2, and VEGF165 significantly increased BV/TV and the rate of bone growth, while the BMP2/VEGF165 showed the best effect among groups. The expression of RUNX2 in HBO, BMP2, and VEGF165/BMP2 group was higher than that in the VEGF165 and control groups at two weeks. The expression of OCN in HBO, BMP2, VEGF165, and VEGF165/BMP2 groups was higher than that in the control group, and the gene expression of CD31 was higher in HBO, VEGF165, and BMP2/VEGF165 groups than that in control and BMP2 groups. Conclusion HBO, BMP2, and VEGF165 could increase bone formation around the implant and improved the implant stability in irradiated bone. The combination use of BMP2 and VEGF165 may be promising in the treatment of implant patients with radiotherapy.
Collapse
|
6
|
Puryer J, Forbes-Haley C. An Implant-Retained Obturator – A Case Study. ACTA ACUST UNITED AC 2017; 44:415-8, 421-2. [PMID: 29188695 DOI: 10.12968/denu.2017.44.5.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This case describes the oral rehabilitation of a patient following maxillary hemi-section due to squamous cell carcinoma of the palate. Planned treatment was construction of a maxillary implant-supported obturator. Two dental implants were placed in his maxilla to aid the support and retention of an obturator. However, owing to bone availability, their angulation was suboptimal and compromised the retention of the obturator. This case describes alternative implant attachments to aid the retention and stability of implant-retained dentures constructed in cases with suboptimal implant placement. Clinical relevance: This case highlights the importance of careful planning for implant placement, and reinforces the need to plan the prostheses before implant surgery. This case highlights possible difficulties that can arise if implants are non-ideally angulated, and how to adapt restorations to manage such difficulties in cases with maxillary removable prostheses.
Collapse
|
7
|
Corte GM, Plendl J, Hünigen H, Richardson KC, Gemeinhardt O, Niehues SM. Refining experimental dental implant testing in the Göttingen Minipig using 3D computed tomography-A morphometric study of the mandibular canal. PLoS One 2017; 12:e0184889. [PMID: 28910382 PMCID: PMC5599038 DOI: 10.1371/journal.pone.0184889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/01/2017] [Indexed: 11/18/2022] Open
Abstract
This study reports morphometric and age-related data of the mandibular canal and the alveolar ridge of the Göttingen Minipig to avoid complications during in vivo testing of endosseus dental implants and to compare these data with the human anatomy. Using 3D computed tomography, six parameters of the mandibular canal as well as the alveolar bone height and the alveolar ridge width were measured in Göttingen Minipigs aged 12, 17 and 21 months. Our null hypothesis assumes that the age and the body mass have an influence on the parameters measured. The study found that the volume, length and depth of the mandibular canal all increase with age. The width of the canal does not change significantly with age. The body mass does not have an influence on any of the measured parameters. The increase in canal volume appears to be due to loss of deep spongy bone in the posterior premolar and molar regions. This reduces the available space for dental implantations, negatively affecting implant stability and potentially the integrity of the inferior alveolar neurovascular bundle. Dynamic anatomical changes occur until 21 months. On ethical grounds, using minipigs younger than 21 months in experimental implant dentistry is inadvisable. Paradoxically the measurements of the 12 months old pigs indicate a closer alignment of their mandibular anatomy to that of humans suggesting that they may be better models for implant studies. Given the variability in mandibular canal dimensions in similar age cohorts, the use of imaging techniques is essential for the selection of individual minipigs for dental prosthetic interventions and thus higher success rates.
Collapse
Affiliation(s)
- Giuliano M. Corte
- Institute of Veterinary Anatomy, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- * E-mail:
| | - Johanna Plendl
- Institute of Veterinary Anatomy, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Hana Hünigen
- Institute of Veterinary Anatomy, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Kenneth C. Richardson
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia
| | - Ole Gemeinhardt
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan M. Niehues
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
8
|
Arnold CR, Kloss F, Singh S, Vasiljevic D, Stigler R, Auberger T, Wenzel V, Klima G, Lukas P, Lepperdinger G, Gassner R. A domestic porcine model for studying the effects of radiation on head and neck cancers. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:536-543. [PMID: 28130028 DOI: 10.1016/j.oooo.2016.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/11/2016] [Accepted: 11/25/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Radiation therapy (RT) of the head and neck region is often accompanied by serious side effects. Research in this area is needed to improve treatment outcomes and ameliorate therapy tolerance. Laboratory rodents are barely matching today's clinical standards in RT research. Yet domestic swine (Sus scrofa domestica) have previously proved suitable for various advanced tests in clinical research and training. We therefore investigated whether S. scrofa domestica is also appropriate for irradiation of the mandible. STUDY DESIGN A common scheme for irradiation treatment of S. scrofa domestica mandibles in a split-mouth design was acquired by applying computed tomography (CT) scanning under sedation. Basing on close anatomic resemblance, a standard treatment plan comprising 2 opposed irradiation fields could be accomplished. RESULTS RT was carried out in a clinical environment with 2 × 9 Gy. The resulting operating procedure facilitated complication-free sedation, transport, positioning, CT scanning, and effective irradiation. CONCLUSION Based on common standards applied for RT in humans, domestic pigs can be employed to progress RT clinical research. Due to their human-like anatomy, physiology, size, and weight, the swine model is expedient for advancing experimental RT of the head and neck area.
Collapse
Affiliation(s)
- Christoph R Arnold
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria.
| | - Frank Kloss
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | | | - Danijela Vasiljevic
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Robert Stigler
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Thomas Auberger
- Department of Radiotherapy-Radiooncology, Hospital Traunstein, Traunstein, Germany
| | - Volker Wenzel
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Günter Klima
- Division of Histology and Embryology, Innsbruck Medical University, Innsbruck, Austria
| | - Peter Lukas
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Günter Lepperdinger
- Institute for Biomedical Aging Research, Innsbruck, Austria; Department of Cell Biology, University Salzburg, Salzburg, Austria
| | - Robert Gassner
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| |
Collapse
|
9
|
Smith Nobrega A, Santiago JF, de Faria Almeida DA, dos Santos DM, Pellizzer EP, Goiato MC. Irradiated patients and survival rate of dental implants: A systematic review and meta-analysis. J Prosthet Dent 2016; 116:858-866. [DOI: 10.1016/j.prosdent.2016.04.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
|
10
|
Ocaña RP, Rabelo GD, Sassi LM, Rodrigues VP, Alves FA. Implant osseointegration in irradiated bone: an experimental study. J Periodontal Res 2016; 52:505-511. [PMID: 27624290 DOI: 10.1111/jre.12416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to evaluate the effect of radiotherapy on the osseointegration of dental implants in the tibia and the action of platelet-rich plasma (PRP) as an adjuvant therapy. MATERIAL AND METHODS A total of 18 rabbits received two implants in each tibial epiphysis, totalizing 72 implants. The control group (group I) was composed by six rabbits and did not receive radiotherapy. The test groups (II and III) received a single dose of 1727 cGy. Group II was composed by six irradiated animals and group III by six animals that received irradiation and PRP during implant placement. The implant success rate, the bone-implant contact (BIC), and the bone volume were analyzed. RESULTS There was no osseointegration in four of the implants, three in group II and one in group III. Total BIC was significantly higher in group I, when compared to the other groups. There was a significant difference of osteoid BIC only between irradiated animals (group II, 8.5%; group III, 4.7%; p = 0.001). On the other hand, the mineralized BIC was significantly higher in group I. Furthermore, group II had a lower mineralized BIC than group III (p = 0.002). Bone volume was higher in the control group (41.3%), followed by group III (33.4%) and II (25.1%), with differences between groups I and II (p = 0.001) and groups II and III (p = 0.022). CONCLUSIONS The present study showed that both the bone volume and BIC were higher in the control group. However, the failure rates of the implants were low in both irradiated groups. The PRP was a positive adjuvant in the osseointegration process.
Collapse
Affiliation(s)
- R P Ocaña
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil
| | - G D Rabelo
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil
| | - L M Sassi
- Department of Stomatology, Erasto Gaertner Cancer Hospital, Curitiba, Brazil
| | - V P Rodrigues
- Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - F A Alves
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil.,Department of Stomatology, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
11
|
Rana MC, Solanki S, Pujari SC, Shaw E, Sharma S, Anand A, Singh HP. Assessment of the Survival of Dental Implants in Irradiated Jaws Following Treatment of Oral Cancer: A Retrospective Study. Niger J Surg 2016; 22:81-85. [PMID: 27843270 PMCID: PMC5013747 DOI: 10.4103/1117-6806.182741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In patients undergoing head and neck surgery for various pathologic conditions, implants are one of the best restorative options and are increasing widely used. Therefore, we evaluated the success of dental implants in the irradiated jaws of patients following treatment of oral cancer oral cancer treated patients. MATERIALS AND METHODS Data of oral cancer treated patients was collected retrospectively from 2002 to 2008. We took 46 oral cancer treated patients in which implants were placed in irradiated jaws for rehabilitation. RESULTS It was found that out of 162 dental implants placed, 52 failed. Furthermore, there was no variation in the implant survival rate in between both the jaws. Radiation dose of <50 Gy units also showed significantly increased amount of implant survival rate. CONCLUSIONS Implant survival is multifactorial and depends upon a number of factors like level of radiation exposure in that area, time gap between last radiation doses etc., Further research is required in this field to improve the esthetics and quality of life of cancer treated patients.
Collapse
Affiliation(s)
- Meenakshi Chauhan Rana
- Department of Oral and Maxillofacial Surgery, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Swati Solanki
- Department of Prosthodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Sudarshan C Pujari
- Department of Conservative Dentistry and Endodontics, PDU Dental College, Solapur, Maharashtra, India
| | - Eisha Shaw
- Department of Prosthodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Swati Sharma
- Department of Pedodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Abhishek Anand
- Department of Pedodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Harkanwal Preet Singh
- Department of Oral Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| |
Collapse
|
12
|
Effect of radiotherapy on osseointegration of dental implants immediately placed in postextraction sites of minipigs mandibles. IMPLANT DENT 2014; 23:560-4. [PMID: 25192164 DOI: 10.1097/id.0000000000000150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to compare the osseointegration and the survival of dental implants (DIs) immediately placed in postextraction sites, in mandibles of minipigs that underwent radiotherapy (RT). MATERIALS AND METHODS Twelve Brazilian minipigs were divided into the following groups: A, control; B, implants placement 15 days before RT; C, implants placement 3 months after RT. Implant loss rate (ILR), fibrointegration rate (FIR), bone-implant contact (BIC), and bone density inside the threads (BDIT) were determined in each group 90 days after implantation. RESULTS ILR was higher in group C (68.7%) than in groups B (28.1%) and A (21.9%), (P = 0.001). FIR was more frequent in group C (30%) than in groups B (21.7%) and A (4%), although not statistically significant. The averages of BIC and BDIT were, respectively, 33.1 and 41.5 in group C; 18.5 and 26.6 in group B; and 11.5 and 16.3 in group A (P = 0.003 for both variables). CONCLUSIONS RT showed a negative effect in periimplant bone regeneration. The implants placement before RT showed better results compared with the implants performed after RT, suggesting that DIs in head and neck cancer patients must be placed before RT or simultaneously during ablative tumor surgery.
Collapse
|
13
|
Gómez-de Diego R, Mang-de la Rosa MDR, Romero-Pérez MJ, Cutando-Soriano A, López-Valverde-Centeno A. Indications and contraindications of dental implants in medically compromised patients: update. Med Oral Patol Oral Cir Bucal 2014; 19:e483-9. [PMID: 24608222 PMCID: PMC4192572 DOI: 10.4317/medoral.19565] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 09/20/2013] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to review the current scientific literature in order to analyse the indications and contraindications of dental implants in medically compromised patients. A reference research was carried out on PubMed using the key words “implant” AND (oral OR dental) AND (systemic disease OR medically compromised), in articles published between 1993 and 2013. The inclusion criteria were the following: clinical studies in which, at least, 10 patients were treated, consensus articles, reviewed articles and meta-analysis performed in humans treated with dental implants, and which included the disease diagnosis. A total of 64 articles were found, from which 16 met the inclusion criteria.
Cardiac systemic diseases, diabetic endocrine pathologies or controlled metabolic disorders do not seem to be a total or partial contraindication to the placement of dental implants. Tobacco addiction, and head and neck radiotherapy are correlated to a higher loss of dental implants. Patients suffering from osteoporosis undergoing biphosphonates therapy show an increased risk of developing bone necrosis after an oral surgery, especially if the drugs are administered intravenously or they are associated to certain concomitant medication.
Key words:Dental implants, medically compromised patient, systemic diseases.
Collapse
Affiliation(s)
- Rafael Gómez-de Diego
- Departamento Cirugía, Universidad de Salamanca, Avda. Alfonso X El Sabio S/N, 37007 Salamanca, Spain,
| | | | | | | | | |
Collapse
|
14
|
Local application of zoledronate enhances miniscrew implant stability in dogs. Am J Orthod Dentofacial Orthop 2014; 145:737-49. [DOI: 10.1016/j.ajodo.2014.01.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 01/01/2014] [Accepted: 01/01/2014] [Indexed: 11/23/2022]
|
15
|
Rysz M, Ciszek B, Rogowska M, Krajewski R. Arteries of the anterior wall of the maxilla in sinus lift surgery. Int J Oral Maxillofac Surg 2014; 43:1127-30. [PMID: 24703496 DOI: 10.1016/j.ijom.2014.02.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 01/22/2014] [Accepted: 02/27/2014] [Indexed: 11/18/2022]
Abstract
Knowledge of the anatomical course of the anterior maxillary wall and alveolar process arteries is essential for sinus lift procedures. The aim of this study was to analyse the localization of anastomoses between the infraorbital and posterior superior alveolar artery on 101 computed tomography (CT) scans of maxillary sinuses (patients aged 18-70 years). The distance from the anastomosis to the bone point was measured on CT scans for each tooth location; for edentulous patients measurements were made to the lower edge of the alveolar process, and for dentate patients to the neck of the tooth. Measurements were done independently by two observers. The anastomosis analysed was identified on 50% of CT scans. The distance to the anastomosis was longest above the premolar (20.4 mm from tooth cervical line) and shortest above the first molar (15.9 mm to the edge of the alveolar process). The anastomosis can be localized on a CT scan for exact positioning of the antrotomy in 50% of patients. For the remaining patients, the anatomical information provided in this study can be used to reduce the risk of damage to the anastomosis. This study provides information on the distance from the anastomosis to the neck of preserved teeth in partially edentulous patients, which can be used as a reference point during sinus lift procedures.
Collapse
Affiliation(s)
- M Rysz
- Department of Descriptive and Clinical Anatomy, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland; Head and Neck Cancer Department, Memorial Cancer Center, Warsaw, Poland.
| | - B Ciszek
- Department of Descriptive and Clinical Anatomy, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - M Rogowska
- Second Clinical Radiology Department, Medical University of Warsaw, Warsaw, Poland
| | - R Krajewski
- Head and Neck Cancer Department, Memorial Cancer Center, Warsaw, Poland
| |
Collapse
|
16
|
Chambrone L, Mandia J, Shibli JA, Romito GA, Abrahao M. Dental implants installed in irradiated jaws: a systematic review. J Dent Res 2013; 92:119S-30S. [PMID: 24158336 DOI: 10.1177/0022034513504947] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to assess the survival rate of titanium implants placed in irradiated jaws. MEDLINE, EMBASE, and CENTRAL were searched for studies assessing implants that had been placed in nongrafted sites of irradiated patients. Random effects meta-analyses assessed implant loss in irradiated versus nonirradiated patients and in irradiated patients treated with hyperbaric oxygen (HBO) therapy. Of 1,051 potentially eligible publications, 15 were included. A total of 10,150 implants were assessed in the included studies, and of these, 1,689 (14.3%) had been placed in irradiated jaws. The mean survival rate in the studies ranged from 46.3% to 98.0%. The pooled estimates indicated a significant increase in the risk of implant failure in irradiated patients (risk ratio: 2.74; 95% confidence interval: 1.86, 4.05; p < .00001) and in maxillary sites (risk ratio: 5.96; 95% confidence interval: 2.71, 13.12; p < .00001). Conversely, HBO therapy did not reduce the risk of implant failure (risk ratio: 1.28; 95% confidence interval: 0.19, 8.82; p = .80). Radiotherapy was linked to higher implant failure in the maxilla, and HBO therapy did not improve implant survival. Most included publications reported data on machined implants, and only 3 studies on HBO therapy were included. Overall, implant therapy appears to be a viable treatment option for reestablishing adequate occlusion and masticatory conditions in irradiated patients.
Collapse
Affiliation(s)
- L Chambrone
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | | | | | | | |
Collapse
|
17
|
von Wilmowsky C, Moest T, Nkenke E, Stelzle F, Schlegel KA. Implants in bone: part II. Research on implant osseointegration: material testing, mechanical testing, imaging and histoanalytical methods. Oral Maxillofac Surg 2013; 18:355-72. [PMID: 23430020 DOI: 10.1007/s10006-013-0397-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/04/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE In order to determine whether a newly developed implant material conforms to the requirements of biocompatibility, it must undergo rigorous testing. To correctly interpret the results of studies on implant material osseointegration, it is necessary to have a sound understanding of all the testing methods. The aim of this overview is to elucidate the methods that are used for the experimental evaluation of the osseointegration of implant materials. DISCUSSION In recent decades, there has been a constant proliferation of new materials and surface modifications in the field of dental implants. This continuous development of innovative biomaterials requires a precise and detailed evaluation in terms of biocompatibility and implant healing before clinical use. The current gold standard is in vivo animal testing on well validated animal models. However, long-term outcome studies on patients have to follow to finally validate and show patient benefit. CONCLUSION No experimental set-up can provide answers for all possible research questions. However, a certain transferability of the results to humans might be possible if the experimental set-up is carefully chosen for the aspects and questions being investigated. To enhance the implant survival rate in the rising number of patients with chronic diseases which compromise wound healing and osseointegration, dental implant research on compromised animal models will further gain importance in future.
Collapse
Affiliation(s)
- Cornelius von Wilmowsky
- Mund-,Kiefer- und Gesichtschirurgische Klinik Universitätsklinikum Erlangen, Glückstrasse 11, 91054, Erlangen, Germany,
| | | | | | | | | |
Collapse
|
18
|
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.
Collapse
Affiliation(s)
- Takako Imai Tanaka
- Department of Biomedical & Diagnostic Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI, USA.
| | | | | | | | | |
Collapse
|
19
|
Thoma DS, Martin IS, Mühlemann S, Jung RE. Systematic review of pre-clinical models assessing implant integration in locally compromised sites and/or systemically compromised animals. J Clin Periodontol 2012; 39 Suppl 12:37-62. [PMID: 22533946 DOI: 10.1111/j.1600-051x.2011.01833.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim was to systematically search the dental literature for pre-clinical models assessing implant integration in locally compromised sites (part 1) and systemically compromised animals (part 2), and to evaluate the quality of reporting of included publications. METHODS A Medline search (1966-2011) was performed, complimented by additional hand searching. The quality of reporting of the included publications was evaluated using the 20 items of the ARRIVE (Animals in Research In Vivo Experiments) guidelines. RESULTS One-hundred and seventy-six (part 1; mean ARRIVE score = 15.6 ± 2.4) and 104 (part 2; 16.2 ± 1.9) studies met the inclusion criteria. The overall mean score for all included studies amounted to 15.8 ± 2.2. Housing (38.3%), allocation of animals (37.9%), numbers analysed (50%) and adverse events (51.4%) of the ARRIVE guidelines were the least reported. Statistically significant differences in mean ARRIVE scores were found depending on the publication date (p < 0.05), with the highest score of 16.7 ± 1.6 for studies published within the last 2 years. CONCLUSIONS A large number of studies met the inclusion criteria. The ARRIVE scores revealed heterogeneity and missing information for selected items in more than 50% of the publications. The quality of reporting shifted towards better-reported pre-clinical trials within recent years.
Collapse
Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
| | | | | | | |
Collapse
|
20
|
Distraction osteogenesis after irradiation in rabbit mandibles. Br J Oral Maxillofac Surg 2012; 50:662-7. [DOI: 10.1016/j.bjoms.2011.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 10/19/2011] [Indexed: 11/15/2022]
|
21
|
Kloss FR, Singh S, Hächl O, Rentenberger J, Auberger T, Kraft A, Klima G, Mitterlechner T, Steinmüller-Nethl D, Lethaus B, Rasse M, Lepperdinger G, Gassner R. BMP-2 immobilized on nanocrystalline diamond-coated titanium screws; demonstration of osteoinductive properties in irradiated bone. Head Neck 2012; 35:235-41. [DOI: 10.1002/hed.22958] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2011] [Indexed: 11/07/2022] Open
|
22
|
Stewart FA, Akleyev AV, Hauer-Jensen M, Hendry JH, Kleiman NJ, Macvittie TJ, Aleman BM, Edgar AB, Mabuchi K, Muirhead CR, Shore RE, Wallace WH. ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs--threshold doses for tissue reactions in a radiation protection context. Ann ICRP 2012; 41:1-322. [PMID: 22925378 DOI: 10.1016/j.icrp.2012.02.001] [Citation(s) in RCA: 795] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This report provides a review of early and late effects of radiation in normal tissues and organs with respect to radiation protection. It was instigated following a recommendation in Publication 103 (ICRP, 2007), and it provides updated estimates of 'practical' threshold doses for tissue injury defined at the level of 1% incidence. Estimates are given for morbidity and mortality endpoints in all organ systems following acute, fractionated, or chronic exposure. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin; and the eye. Particular attention is paid to circulatory disease and cataracts because of recent evidence of higher incidences of injury than expected after lower doses; hence, threshold doses appear to be lower than previously considered. This is largely because of the increasing incidences with increasing times after exposure. In the context of protection, it is the threshold doses for very long follow-up times that are the most relevant for workers and the public; for example, the atomic bomb survivors with 40-50years of follow-up. Radiotherapy data generally apply for shorter follow-up times because of competing causes of death in cancer patients, and hence the risks of radiation-induced circulatory disease at those earlier times are lower. A variety of biological response modifiers have been used to help reduce late reactions in many tissues. These include antioxidants, radical scavengers, inhibitors of apoptosis, anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, growth factors, and cytokines. In many cases, these give dose modification factors of 1.1-1.2, and in a few cases 1.5-2, indicating the potential for increasing threshold doses in known exposure cases. In contrast, there are agents that enhance radiation responses, notably other cytotoxic agents such as antimetabolites, alkylating agents, anti-angiogenic drugs, and antibiotics, as well as genetic and comorbidity factors. Most tissues show a sparing effect of dose fractionation, so that total doses for a given endpoint are higher if the dose is fractionated rather than when given as a single dose. However, for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease, it appears that the rate of dose delivery does not modify the low incidence. This implies that the injury in these cases and at these low dose levels is caused by single-hit irreparable-type events. For these two tissues, a threshold dose of 0.5Gy is proposed herein for practical purposes, irrespective of the rate of dose delivery, and future studies may elucidate this judgement further.
Collapse
|
23
|
Katsoulis J, Avrampou M, Spycher C, Stipic M, Enkling N, Mericske-Stern R. Comparison of Implant Stability by Means of Resonance Frequency Analysis for Flapless and Conventionally Inserted Implants. Clin Implant Dent Relat Res 2011; 14:915-23. [DOI: 10.1111/j.1708-8208.2010.00326.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Yamauchi K, Takahashi T, Funaki K, Miyamoto I, Yamashita Y. Implant placement for periosteal expansion osteogenesis using β-tricalcium phosphate block: An experimental study in dogs. ACTA ACUST UNITED AC 2009; 108:861-6. [DOI: 10.1016/j.tripleo.2009.07.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Revised: 07/24/2009] [Accepted: 07/24/2009] [Indexed: 12/01/2022]
|
25
|
Turkyilmaz I, McGlumphy EA. Influence of bone density on implant stability parameters and implant success: a retrospective clinical study. BMC Oral Health 2008; 8:32. [PMID: 19025637 PMCID: PMC2614413 DOI: 10.1186/1472-6831-8-32] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Accepted: 11/24/2008] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The aim of the present clinical study was to determine the local bone density in dental implant recipient sites using computerized tomography (CT) and to investigate the influence of local bone density on implant stability parameters and implant success. METHODS A total of 300 implants were placed in 111 patients between 2003 and 2005. The bone density in each implant recipient site was determined using CT. Insertion torque and resonance frequency analysis were used as implant stability parameters. The peak insertion torque values were recorded with OsseoCare machine. The resonance frequency analysis measurements were performed with Osstell instrument immediately after implant placement, 6, and 12 months later. RESULTS Of 300 implants placed, 20 were lost, meaning a survival rate of %. 93.3 after three years (average 3.7 +/- 0.7 years). The mean bone density, insertion torque and RFA recordings of all 300 implants were 620 +/- 251 HU, 36.1 +/- 8 Ncm, and 65.7 +/- 9 ISQ at implant placement respectively; which indicated statistically significant correlations between bone density and insertion torque values (p < 0.001), bone density and ISQ values (p < 0.001), and insertion torque and ISQ values (p < 0.001). The mean bone density, insertion torque and RFA values were 645 +/- 240 HU, 37.2 +/- 7 Ncm, and 67.1 +/- 7 ISQ for 280 successful implants at implant placement, while corresponding values were 267 +/- 47 HU, 21.8 +/- 4 Ncm, and 46.5 +/- 4 ISQ for 20 failed implants; which indicated statistically significant differences for each parameter (p < 0.001). CONCLUSION CT is a useful tool to determine the bone density in the implant recipient sites, and the local bone density has a prevailing influence on primary implant stability, which is an important determinant for implant success.
Collapse
Affiliation(s)
- Ilser Turkyilmaz
- Department of Prosthodontics, Dental School at San Antonio, University of Texas Health Science Center, San Antonio, Texas, USA.
| | | |
Collapse
|
26
|
Verdonck HWD, Meijer GJ, Nieman FH, Stoll C, Riediger D, de Baat C. Quantitative computed tomography bone mineral density measurements in irradiated and non-irradiated minipig alveolar bone: an experimental study. Clin Oral Implants Res 2008; 19:465-8. [PMID: 18371103 DOI: 10.1111/j.1600-0501.2007.01496.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to analyse the effect of irradiation on bone mineral density (BMD). MATERIALS AND METHODS All maxillary and mandibular pre-molars and molars of six minipigs were extracted. After a 3-month healing period, the maxilla and mandibles of three minipigs received three irradiation exposures at a total dose of 24 Gy. At 3 months after irradiation, quantitative computed tomography (QCT) was performed. As a reference, a calibration bone phantom with pre-determined BMD was attached to the head of the minipigs. The QCT data were imported into a software program to calculate the BMD of the alveolar bone and the calibration bone phantom. In order to compare BMD values of individual minipigs, the so-called bone mineral density quotient (BMDQ) was created, dividing the BMD value of the alveolar bone by the BMD value of the calibration bone phantom. RESULTS Mean BMDQ values appeared to be higher in irradiated than in non-irradiated minipigs. However, the difference was not significant. In both irradiated and non-irradiated minipigs, the average mandibular BMDQ values were statistically significantly higher than the average maxillary BMDQ values (P=0.003). The P-values of the Student t-test, determining the irradiation effect, were 0.11 for maxillary, 0.14 for mandibular, and 0.07 for overall peri-implant BMDQ. P-values of the non-parametric Mann-Whitney test were all 0.05. CONCLUSION It could be concluded that, 3 months after irradiation, the BMD of irradiated alveolar minipig bone was increased, when compared with non-irradiated alveolar minipig bone. However, the increase was not statistically significant.
Collapse
Affiliation(s)
- Henk W D Verdonck
- Department of Oral and Maxillofacial Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
| | | | | | | | | | | |
Collapse
|