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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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Prado-Pena IB, Somoza-Martin JM, García-Carnicero T, Lorenzo-Pouso AI, Pérez-Sayáns M, Sanmartín-Barragáns V, Blanco-Carrión A, García-García A, Gándara-Vila P. Osseointegrated dental implants that will undergo radiotherapy. Does risk of osteoradionecrosis exist? A scoping review. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00323-7. [PMID: 39142935 DOI: 10.1016/j.oooo.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/27/2024] [Accepted: 06/01/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVE Given the absence of a standardized action protocol for treating patients with dental implants (DIs) who are subjected to radiotherapy (RT), we have conducted an extensive review and analysis of published literature on this subject. Our objective is to gain a comprehensive understanding of the impact of RT on the bone surrounding osseointegrated implants during and after treatment. STUDY DESIGN We conducted a literature review using PubMed (MEDLINE) to identify studies describing the effects of RT on preexisting osseointegrated and/or loaded DIs. Articles published between January 1963 and December 2023 were considered for inclusion. RESULTS A total of 1,126 articles were retrieved, 64 full articles were reviewed, and only 13 articles were included in this review upon meeting the criteria. A total of 667 patients and 2,409 implants were included. Osteoradionecrosis (ORN) was observed in approximately 19 implants following antineoplastic treatment. CONCLUSIONS The interaction between DIs and RT is a complex and multifaceted issue that requires further research and clinical guidance. Although certain studies indicate a possible connection between DIs, radiation, and ORN risk, the precise relationship remains unclear. Factors such as radiation dosage, implant characteristics, material, and timing of placement significantly influence this association.
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Affiliation(s)
- Irene Beatriz Prado-Pena
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Jose Manuel Somoza-Martin
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago (IDIS), ORALRES Group Santiago de Compostela, Santiago de Compostela, Spain.
| | - Tamara García-Carnicero
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Alejandro I Lorenzo-Pouso
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago (IDIS), ORALRES Group Santiago de Compostela, Santiago de Compostela, Spain; Materials Institute of Santiago de Compostela (iMATUS), Santiago de Compostela, Spain
| | - Valeria Sanmartín-Barragáns
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago (IDIS), ORALRES Group Santiago de Compostela, Santiago de Compostela, Spain
| | - Abel García-García
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago (IDIS), ORALRES Group Santiago de Compostela, Santiago de Compostela, Spain
| | - Pilar Gándara-Vila
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago (IDIS), ORALRES Group Santiago de Compostela, Santiago de Compostela, Spain
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Mathevosyan D, Hovhannisyan S, Mashinyan K, Khachatryan L, Badalyan A, Hakobyan G. Prosthetic rehabilitation of patients with maxillary oncology defects using zygomatic implants. Int J Implant Dent 2024; 10:31. [PMID: 38856842 PMCID: PMC11164848 DOI: 10.1186/s40729-024-00545-y] [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: 04/13/2024] [Accepted: 05/21/2024] [Indexed: 06/11/2024] Open
Abstract
PURPOSE Prosthetics for patients after oncological resection of the upper jaw is a complex problem associated with the physiological and anatomical separation of the oral cavity and the nasal/paranasal region. This study reports the clinical results of the use of the zygomatic implants for prosthetic rehabilitation in patients with maxillectomy due to upper jaw tumors. MATERIALS AND METHODS The study included 16 patients who underwent prosthetic rehabilitation using a zygomatic implant after maxillectomy period from 2021 to 2023. After the tumor was removed, immediate surgical obturators were placed. Main prosthetic rehabilitation was performed 6-12 months after tumor removal, but before that, a temporary obturator was made and used. Six-twelve months after tumor resection, 1-4 zygomatic implants were inserted into the zygomatic bone unilaterally or bilaterally. A total of 42 zygomatic implants were installed, 2 of which were unsuccessful and were removed in 1 patient. The implants were placed using the surgical guide, which was planned and prepared digitally. RESULTS No postsurgical complications were seen, and the patients were discharged from the hospital after 7-10 days. The patients were able to return to a normal diet (hard food) after just 7 days following surgery, with no further complaints regarding function or pain, apart from the residual edema caused by the intervention. CONCLUSIONS The use of prostheses fixed on zygomatic implants in patients with maxillary defects is an effective method of prosthodontic rehabilitation in complex clinical cases after maxillectomy.
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Affiliation(s)
- Davit Mathevosyan
- Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Abovyan, Armenia
| | - Sergo Hovhannisyan
- Department of Prosthodontics, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Karen Mashinyan
- Department of Prosthodontics, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Levon Khachatryan
- Department Head and Neck Surgery Modern Implant Medicine, Yerevan, Armenia
| | - Aram Badalyan
- Department Head and Neck Surgery, NAIRI Medical Center, Yerevan, Armenia
| | - Gagik Hakobyan
- Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Abovyan, Armenia.
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Sriram S, Njoroge MW, Lopez CD, Zhu L, Heron MJ, Zhu KJ, Yusuf CT, Yang R. Optimal Treatment Order With Fibula-Free Flap Reconstruction, Oncologic Treatment, and Dental Implants: A Systematic Review and Meta-Analysis. J Craniofac Surg 2024; 35:1065-1073. [PMID: 38666786 DOI: 10.1097/scs.0000000000010127] [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: 12/10/2023] [Accepted: 02/05/2024] [Indexed: 06/04/2024] Open
Abstract
Head and neck cancer (HNC) patients benefit from craniofacial reconstruction, but no clear guidance exists for rehabilitation timing. This meta-analysis aims to clarify the impact of oncologic treatment order on implant survival. An algorithm to guide placement sequence is also proposed in this paper. PubMed, Embase, and Web of Science were searched for studies on HNC patients with ablative and fibula-free flap (FFF) reconstruction surgeries and radiotherapy (RTX). Primary outcomes included treatment sequence, implant survival rates, and RTX dose. Of 661 studies, 20 studies (617 implants, 199 patients) were included. Pooled survival rates for implants receiving >60 Gy RTX were significantly lower than implants receiving < 60 Gy (82.8% versus 90.1%, P =0.035). Placement >1 year after RTX completion improved implant survival rates (96.8% versus 82.5%, P =0.001). Implants receiving pre-placement RTX had increased survival with RTX postablation versus before (91.2% versus 74.8%, P <0.001). One hundred seventy-seven implants were placed only in FFF with higher survival than implants placed in FFF or native bone (90.4% versus 83.5%, P =0.035). Radiotherapy is detrimental to implant survival rates when administered too soon, in high doses, and before tumor resection. A novel evidence-based clinical decision-making algorithm was presented for utilization when determining the optimal treatment order for HNC patients. The overall survival of dental prostheses is acceptable, reaffirming their role as a key component in rehabilitating HNC patients. Considerations must be made regarding RTX dosage, timing, and implant location to optimize survival rates and patient outcomes for improved functionality, aesthetics, and comfort.
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Affiliation(s)
- Shreya Sriram
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD
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Marin E, Lanzutti A. Biomedical Applications of Titanium Alloys: A Comprehensive Review. MATERIALS (BASEL, SWITZERLAND) 2023; 17:114. [PMID: 38203968 PMCID: PMC10780041 DOI: 10.3390/ma17010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
Titanium alloys have emerged as the most successful metallic material to ever be applied in the field of biomedical engineering. This comprehensive review covers the history of titanium in medicine, the properties of titanium and its alloys, the production technologies used to produce biomedical implants, and the most common uses for titanium and its alloys, ranging from orthopedic implants to dental prosthetics and cardiovascular devices. At the core of this success lies the combination of machinability, mechanical strength, biocompatibility, and corrosion resistance. This unique combination of useful traits has positioned titanium alloys as an indispensable material for biomedical engineering applications, enabling safer, more durable, and more efficient treatments for patients affected by various kinds of pathologies. This review takes an in-depth journey into the inherent properties that define titanium alloys and which of them are advantageous for biomedical use. It explores their production techniques and the fabrication methodologies that are utilized to machine them into their final shape. The biomedical applications of titanium alloys are then categorized and described in detail, focusing on which specific advantages titanium alloys are present when compared to other materials. This review not only captures the current state of the art, but also explores the future possibilities and limitations of titanium alloys applied in the biomedical field.
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Affiliation(s)
- Elia Marin
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Kyoto 606-8585, Japan
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
- Department Polytechnic of Engineering and Architecture, University of Udine, 33100 Udine, Italy
- Biomedical Research Center, Kyoto Institute of Technology, Sakyo-ku, Kyoto 606-8585, Japan
| | - Alex Lanzutti
- Department Polytechnic of Engineering and Architecture, University of Udine, 33100 Udine, Italy
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Rahmani AH, Almatroudi A, Allemailem KS, Alharbi HOA, Alwanian WM, Alhunayhani BA, Algahtani M, Theyab A, Almansour NM, Algefary AN, Aldeghaim SSA, Khan AA. Role of Mangiferin in Management of Cancers through Modulation of Signal Transduction Pathways. Biomedicines 2023; 11:3205. [PMID: 38137424 PMCID: PMC10741126 DOI: 10.3390/biomedicines11123205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Cancer is a major public health concern worldwide in terms of mortality. The exact reason behind the development of cancer is not understood clearly, but it is evidenced that alcohol consumption, radiation, and exposure to chemicals are main players in this pathogenesis. The current mode of treatments such as surgery, chemotherapy, and radiotherapy are effective, but, still, cancer is a major problem leading to death and other side effects. However, safer and effective treatment modules are needed to overcome the adverse effects of current treatment modules. In this regard, natural compounds have been recognized to ameliorate diseases by exerting anti-inflammatory, anti-oxidative, and anti-tumor potential through several mechanisms. Mangiferin, a xanthone C-glucoside, is found in several plant species including Mangifera indica (mango), and its role in disease prevention has been confirmed through its antioxidant and anti-inflammatory properties. Furthermore, its anti-cancer-potential mechanism has been designated through modulation of cell signaling pathways such as inflammation, angiogenesis, PI3K/AKT, apoptosis, and cell cycle. This article extensively reviews the anticancer potential of mangiferin in different cancers through the modulation of cell signaling pathways. Moreover, the synergistic effects of this compound with some commonly used anti-cancer drugs against different cancer cells are discussed. More clinical trials should be performed to reconnoiter the anti-cancer potential of this compound in human cancer treatment. Further, understanding of mechanisms of action and the safety level of this compound can help to manage diseases, including cancer.
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Affiliation(s)
- Arshad Husain Rahmani
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Ahmad Almatroudi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Khaled S. Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Hajed Obaid A. Alharbi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Wanian M. Alwanian
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Basmah Awwadh Alhunayhani
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Mohammad Algahtani
- Department of Laboratory & Blood Bank, Security Forces Hospital, P.O. Box 14799, Mecca 21955, Saudi Arabia
| | - Abdulrahman Theyab
- Department of Laboratory & Blood Bank, Security Forces Hospital, P.O. Box 14799, Mecca 21955, Saudi Arabia
- College of Medicine, Al-Faisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia
| | - Nahlah Makki Almansour
- Department of Biology, College of Science, University of Hafr Al Batin, Hafr Al Batin 31991, Saudi Arabia
| | - Ahmed N. Algefary
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Solaiman Saleh Ali Aldeghaim
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia (H.O.A.A.); (A.N.A.); (S.S.A.A.)
| | - Amjad Ali Khan
- Department of Basic Health Sciences, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia
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Lombardo G, D'Agostino A, Nocini PF, Signoriello A, Zangani A, Pardo A, Lonardi F, Trevisiol L. Clinical outcomes and periodontal conditions of dental implants placed in free fibula flaps (FFF): a retrospective study with a mean follow-up of 6 years. Clin Oral Investig 2023; 27:7737-7751. [PMID: 37917356 PMCID: PMC10713700 DOI: 10.1007/s00784-023-05364-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES Up-to-date literature regarding long-term success of implant rehabilitations after microvascular reconstructions with free fibula flap (FFF) is still very scarce. This study aimed to evaluate clinical outcomes, especially related to oral hygiene conditions, of patients rehabilitated with this technique. MATERIALS AND METHODS A total of 25 patients who underwent maxillofacial reconstructive surgery with FFF were retrospectively evaluated for soft tissues conditions, oral hygiene habits, and implant survival and success, assessed with a mean follow-up of 6 (range 2-15) years after loading. RESULTS Fourteen patients received full-arch fixed prostheses and 11 removable bar-supported overdentures. At the follow-up evaluation, 52% of prostheses did not allow proper accessibility for oral hygiene. Overall prosthetic survival was 100%, and implant survival and success were respectively 93.6% and 72%. Prevalence of peri-implantitis was 29% at implant level and that at patient level 96%. CONCLUSIONS Six-year clinical outcomes of this study reveal that poor oral hygiene practices and compliance by patients who underwent maxillofacial reconstruction with FFF are significantly associated with peri-implant disease. CLINICAL RELEVANCE Findings of the present study underline the need by clinicians for a careful assessment, in reference to a specific implant therapy, of patient's prosthetic accessibility for oral hygiene procedures.
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Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Antonio D'Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Alessia Pardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Fabio Lonardi
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Lorenzo Trevisiol
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
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8
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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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9
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Avelino SOM, Neves RM, Sobral-Silva LA, Tango RN, Federico CA, Vegian MRC, de Almeida-Silva LA, Kaminagakura E, Amorim JBO, Vasconcellos LMR. Evaluation of the Effects of Radiation Therapy on Muscle Contractibility and Skin Healing: An Experimental Study of the Cancer Treatment Implications. Life (Basel) 2023; 13:1838. [PMID: 37763242 PMCID: PMC10532574 DOI: 10.3390/life13091838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Radiotherapy can affect healthy cells, resulting in side effects. This study aimed to assess the impact of radiotherapy on soft tissue in surgical wounds in rats. METHODS The animals were divided into four groups: control (S) group without irradiation, immediate irradiation (S-IIr) group receiving irradiation right after surgery, late irradiation (S-LIr) group receiving irradiation four weeks after surgery, and early irradiation (Ir-S) group receiving irradiation before surgery. The irradiated groups underwent two fractional stages of 15 Gy. Muscle contractibility (EMG) was evaluated at two different time points, and after 2 and 7 weeks, the animals were euthanized for histological analysis of the muscles and skin. RESULTS There was no significant difference between the EMG1 and EMG2 values of the S and S-LIr groups, but both S-IIr and Ir-S groups exhibited a statistically significant difference. The S group demonstrated a larger diameter of muscle fiber compared to other groups, showing a significant difference. In terms of skin analysis, the S-IIr group had the least inflammatory infiltrate and the highest amount of red fibers, differing significantly from the other groups. CONCLUSIONS Regardless of the duration, radiotherapy was found to have effects on the surrounding soft tissues, as concluded by this study.
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Affiliation(s)
- Sarah O. M. Avelino
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - Rafael M. Neves
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - Leonardo A. Sobral-Silva
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - Rubens N. Tango
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - Claudio A. Federico
- Department of Aerospace Science and Technology, Institute of Advanced Studies, Technological Institute of Aeronautics (ITA), Praça Marechal Eduardo Gomes, 50, Vila das Acacias, São José dos Campos 12228-615, SP, Brazil
| | - Mariana R. C. Vegian
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - Luis Augusto de Almeida-Silva
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - Estela Kaminagakura
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - José Benedito O. Amorim
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
| | - Luana M. R. Vasconcellos
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos 12245-001, SP, Brazil
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Tahmasebi E, Keykha E, Hajisadeghi S, Moslemi H, Shafiei S, Motamedi MHK, Torabizadeh A, Tabrizi R, Alam M. Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis. Maxillofac Plast Reconstr Surg 2023; 45:24. [PMID: 37418121 DOI: 10.1186/s40902-023-00392-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region. MAIN TEXT We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane's CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case-control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran's Q test and the I2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. CONCLUSIONS Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.
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Affiliation(s)
- Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
- School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Elham Keykha
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
- School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Samira Hajisadeghi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
- School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamidreza Moslemi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervin Shafiei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Kalantar Motamedi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | | | - Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Zierden K, Wöstmann J, Wöstmann B, Rehmann P. Clinical performance of different types of dental prosthesis in patients with head and neck tumors-a retrospective cohort study. Clin Oral Investig 2022; 26:7121-7133. [PMID: 35976496 PMCID: PMC9708759 DOI: 10.1007/s00784-022-04673-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/09/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate how different types of dental prosthesis perform in patients with head and neck tumors. MATERIALS AND METHODS In this retrospective clinical cohort study, the impact of different patient-related factors was analyzed as influencing factors on the survival probability of dental prosthesis using Kaplan-Meier estimate. For analysis, the dental prosthesis was divided into groups: group 1 (fixed dental prosthesis), group 2 (removable dental prosthesis), group 3 (implant-supported dental prosthesis), and group 4 (prostheses anchored using wrought wire clasps and obturators). The incidental aftercare measures were also evaluated. RESULTS Two hundred seventy-nine restorations were observed (mean observation: 2.7 ± 3.0 years, max.14.8 years) out of which 49 (17.6%) had to be replaced during the observation. After 5 years, 100% of group 1 restorations, 79.9% of group 2 restorations, 91.4% of group 3 restorations, and 30% of group 4 restorations were still functional. Four hundred eighty-eight dental implants were observed, of which 77 (15.8%) failed. CONCLUSIONS Groups 1, 2, and 3 restorations showed good survival times after 5 years in function, whereas group 4 presented the worst survival times. Group 2 restorations showed the highest amount of necessary aftercare measures. CLINICAL RELEVANCE The current investigation shows that groups 1, 2, and 3 restorations should be preferred in the prosthetic treatment planning of patients with head and neck tumors. A treatment with group 4 restorations should only be considered if no other prosthetic treatment is possible or as temporary treatment.
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Affiliation(s)
- Karina Zierden
- Department of Prosthodontics, School of Dental Medicine, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany.
| | | | - Bernd Wöstmann
- Department of Prosthodontics, School of Dental Medicine, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Peter Rehmann
- Department of Prosthodontics, School of Dental Medicine, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
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12
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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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13
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Kende PP, Ranganath S, Landge JS, Sarda A, Wadewale M, Patil A, Singhavi HR. Survival of Dental Implants on Irradiated Jaws: A Systematic Review and Meta-analysis. J Maxillofac Oral Surg 2022; 21:787-795. [PMID: 36274870 PMCID: PMC9474974 DOI: 10.1007/s12663-022-01686-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/03/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives Dental implants play a significant role in functional rehabilitation of the oral cavity after debilitating jaw surgeries for oral cavity cancers followed by radiotherapy. Design The meta-analysis was done using Preferred Reporting Items for Systematic Review (PRISMA) guidelines published from January 1947 till August 2020. Twenty three articles consisting of 1246 participants with 4838 implants were included in our analysis. Results The mean age of the included participants was 51.4 years. 2186 and 1685 implants were placed on irradiated and non-irradiated jaws and showed a success rate of 82.47% and 89.37% respectively. Correspondingly, publication bias of p value = 0.2129 and p-value = 0.6525 was found by Egger's and Begg's test respectively for pooled data of 16 studies. The implant success rate of 70.4% on maxillary bone and 94.5% were observed on mandibular bone. Timing of implant placement and its influence on survival rate have resulted in a 75.5% survival rate of dental implants when placed primarily in comparison with 87.7% on delayed placement. The waiting interval of 14 months in delayed implant placement has shown better results. Conclusion Presence of radiotherapy does not play a significant role in the success rate of dental implants in oral cavity cancers. However, delayed implant placement may have a better chance of survival. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-022-01686-6.
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Affiliation(s)
- Prajwalit Prakash Kende
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, 400001 India
| | - Suleka Ranganath
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, 400001 India
| | - Jayant Shivaji Landge
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, 400001 India
| | - Ashish Sarda
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, 400001 India
| | - Maroti Wadewale
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, 400001 India
| | - Akshay Patil
- Department of Biostatistics, Tata Memorial Hospital, Mumbai, India
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14
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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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Systemic Literature Review on Multilevel Analysis of Radiation Effects on Bone Microarchitecture. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9890633. [PMID: 35782085 PMCID: PMC9249517 DOI: 10.1155/2022/9890633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 11/19/2022]
Abstract
Introduction Modern radiation therapy has become an effective method to treat and monitor tumour growth in cancer patients. It has proved to be a successful way to minimise mortality rates. However, the adverse effects of radiation have been historical evidence in the clinical environment involving diminishing the quality and density of bone and causing fragility fracture to the bone in the long run. This systematic review was aimed at identifying and evaluating the effects of irradiation on morphology and mechanical properties of murine model bone in previous publications. Methods A systematic literature review was undertaken following the Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA) guidelines. A comprehensive literature search was performed using Scopus, Web of Science, and Science Direct databases (English only studies published between 2015 and 2020). The selected studies were evaluated according to three criteria: (1) criteria for study sample selection; (2) criteria for methodological procedures; and (3) criteria for detection and evaluation. Results The initial search strategy identified 1408 related studies, 8 of were included based on inclusion and exclusion criteria. This review revealed an association between bone destruction and the magnitude of time and dose postirradiation. We agreed that the effect of radiation on bone morphology and strength primarily is a later stage event but noticeable in both low (1 Gy) and high dose (30 Gy) radiation. Trabecular and cortical bone microstructures were significantly altered at irradiation and contralateral sites. Besides, the mechanical strength was significantly impacted in both shorter and longer periods. Conclusion Overall, the radiotherapy altered bone microstructures and substantially decreases bone mechanical properties. The alteration was related to quantity and the activity of the osteoblast and osteoclast. Early detection of those most at risk for radiation-induced bone alterations could lead to better prophylactic intervention decisions.
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Ikbal LK, Emrah S, Kerem K. Dental Implant-Supported Prosthetic Rehabilitation With Custom Attachment in a Patient With Partial Maxillectomy Defect Because of Osteosarcoma: A Case Report. J ORAL IMPLANTOL 2021; 47:518-523. [PMID: 33270861 DOI: 10.1563/aaid-joi-d-20-00021] [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: 11/22/2022]
Abstract
Prosthetic rehabilitation in maxillectomy patients aims to separate the oral and nasal cavities to provide adequate articulation, restore the contour of the midface, and provide acceptable aesthetic results. This clinical case report describes prosthetic rehabilitation via placement of dental implants in the zygomatic bone in a patient who underwent partial maxillectomy because of osteosarcoma. The success of obturator placement after maxillectomy requires retention by the surrounding dental tissue or dental implants. When zygomatic implants cannot be used, dental implants placed in the zygomatic bone and attachments fastened to these implants can easily provide the retention and stability required by the obturator.
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Affiliation(s)
| | - Soylu Emrah
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Kilic Kerem
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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17
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Munhoz L, Nishimura DA, Iida CH, Watanabe PCA, Arita ES. Head and neck radiotherapy-induced changes in dentomaxillofacial structures detected on panoramic radiographs: A systematic review. Imaging Sci Dent 2021; 51:223-235. [PMID: 34621649 PMCID: PMC8479433 DOI: 10.5624/isd.20210011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/17/2021] [Accepted: 02/26/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to “radiotherapy” and synonyms combined with keywords related to “panoramic radiography” and “oral diagnosis” and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | | - Christyan Hiroshi Iida
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Plauto Christopher Aranha Watanabe
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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18
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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.
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19
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Yu H, Zhou A, Liu J, Tang Y, Yuan Q, Man Y, Xiang L. Management of systemic risk factors ahead of dental implant therapy: A beard well lathered is half shaved. J Leukoc Biol 2021; 110:591-604. [PMID: 34231923 DOI: 10.1002/jlb.6mr0621-760rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023] Open
Abstract
As the most successful therapy for missing teeth, dental implant has become increasingly prevalent around the world. A lot of papers have reported diverse local risk factors affecting the success and survival rate of dental implants, either for a short or a long period. However, there are also many types of systemic disorders or relatively administrated medicine that may jeopardize the security and success of dental implant treatment. Additionally, the coronavirus disease 2019 pandemic also poses a challenge to dental implant clinicians. Some of these risk factors are clinically common but to some extent unfamiliar to dentists, thus optimal measurements are often lacking when they occur in dental clinics. In this review, we analyze potential systemic risk factors that may affect the success rate of dental implants. Some of them may affect bone mineral density or enhance the likelihood of local infection, thus impeding osseointegration. Others may even systemically increase the risk of the surgery and threaten patients' life. In order to help novices receive high-risk patients who need to get dental implant treatment in a more reasonable way, we accordingly review recent research results and clinical experiments to discuss promising precautions, such as stopping drugs that impact bone mineral density or the operation, and addressing any perturbations on vital signs.
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Affiliation(s)
- Hui Yu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Anqi Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiayi Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yufei Tang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Quan Yuan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Xiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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20
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Immediate dental implant placement and restoration in the edentulous mandible in head and neck cancer patients: a systematic review and meta-analysis. Curr Opin Otolaryngol Head Neck Surg 2021; 29:126-137. [PMID: 33278135 PMCID: PMC7969163 DOI: 10.1097/moo.0000000000000685] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Oral rehabilitation with dental implants in head and neck cancer (HNC) patients is challenging. After tooth removal prior to radiotherapy, immediate placement of dental implants during panendoscopy or surgery is thought to reduce the oral rehabilitation time improving patients' quality of life. RECENT FINDINGS There is lack of consensus on the timing of dental implant placement and loading protocols. The aim of this study was to perform a systematic review of the literature regarding the performance and survival rate of immediately inserted dental implants placed prior to radiotherapy. Of 1003 articles, 10 were finally included comparing immediate vs. delayed placement of implants and comparing the effect of radiotherapy on immediately placed implants. Meta-analysis demonstrated a slightly higher survival of immediately placed implants compared with postponed placed implants [risk ratio: 0.92, 95% confidence interval (95% CI): 0.48-1.78, P = 0.81, I2 = 0%]. The other meta-analysis comparing radiotherapy vs. nonradiotherapy showed a clearly better survival of immediately placed implants not having received radiotherapy (risk ratio: 5.02, 95% CI: 0.92-27.38, P = 0.10, I2 = 56%). SUMMARY Guidelines are recommended for immediate dental implant placement in the edentulous mandible in HNC patients prior to radiotherapy to allow homogeneity regarding the treatment protocols and thus comparison of treatment outcomes.
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21
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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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22
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Baijens LWJ, Walshe M, Aaltonen LM, Arens C, Cordier R, Cras P, Crevier-Buchman L, Curtis C, Golusinski W, Govender R, Eriksen JG, Hansen K, Heathcote K, Hess MM, Hosal S, Klussmann JP, Leemans CR, MacCarthy D, Manduchi B, Marie JP, Nouraei R, Parkes C, Pflug C, Pilz W, Regan J, Rommel N, Schindler A, Schols AMWJ, Speyer R, Succo G, Wessel I, Willemsen ACH, Yilmaz T, Clavé P. European white paper: oropharyngeal dysphagia in head and neck cancer. Eur Arch Otorhinolaryngol 2021; 278:577-616. [PMID: 33341909 PMCID: PMC7826315 DOI: 10.1007/s00405-020-06507-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. METHODS Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. RESULTS Twenty-four sections on HNC-specific OD topics. CONCLUSION This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.
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Affiliation(s)
- Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Otto-von-Guericke University, Magdeburg, Germany
| | - Reinie Cordier
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Patrick Cras
- Department of Neurology, Born Bunge Institute, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Lise Crevier-Buchman
- Voice, Speech, Swallowing Lab, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UVSQ and Research lab CNRS-UMR7018, Hôpital Foch, Suresnes, France
| | - Chris Curtis
- Swallows Head and Neck Cancer Charity, Blackpool, UK
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan University of Medical Sciences, Poznan, Poland
| | - Roganie Govender
- Head and Neck Cancer Centre, University College London Hospital, London, UK
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Kevin Hansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kate Heathcote
- Robert White Centre for Airway, Voice and Swallow, Poole Hospital NHS Foundation Trust, Dorset, UK
| | - Markus M Hess
- Deutsche Stimmklinik, Hamburg, Germany
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sefik Hosal
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Atılım University, Medicana International Ankara, Ankara, Turkey
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - C René Leemans
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
| | - Denise MacCarthy
- Division of Restorative Dentistry and Periodontology, Faculty of Health Sciences, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Beatrice Manduchi
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Jean-Paul Marie
- Department of Otorhinolaryngology, Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Reza Nouraei
- Department of Ear Nose and Throat Surgery, The Robert White Centre for Airway Voice and Swallowing, Poole Hospital NHS Foundation Trust, University of Southampton, Southampton, UK
| | - Claire Parkes
- Department of Speech and Language Therapy, St. James's Hospital, Dublin, Ireland
| | - Christina Pflug
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Nathalie Rommel
- Department Neurosciences, Experimental Otorhinolaryngology, Deglutology, University of Leuven, Leuven, Belgium
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Renee Speyer
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Health, School of Health and Social Development, Victoria, Australia
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
- Department of Oncology, University of Turin, Orbassano, TO, Italy
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna C H Willemsen
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Taner Yilmaz
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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23
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Silva IFVD, Omaña-Cepeda C, Marí-Roig A, López-López J, Jané-Salas E. Survival of Dental Implants in Oncology Patients versus Non-Oncology Patients: A 5-Year Retrospective Study. Braz Dent J 2020; 31:650-656. [PMID: 33237237 DOI: 10.1590/0103-6440202003622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/20/2020] [Indexed: 12/24/2022] Open
Abstract
Patients with a history of cancer are increasingly common in the dental office. Treating cancer patients requires a multidisciplinary team, which should include the dentist, in order to control the complications that occur in the oral cavity and also to recover the patient undergoing treatment in any of its types: surgical, medical, radiotherapeutic, or its possible combinations. Dental implants can be a safe and predictable treatment option for prosthetic rehabilitation. The aim of this paper is to describe in retrospect the success rate of osseointegrated implants in oncology and non-oncology patients placed by the Master of Dentistry in Oncology and Immunocompromised Patients, as well as the Master of Medicine, Surgery and Oral Implantology of the University of Barcelona Dental Hospital, between July 2011 and March 2016. 466 patients were reviewed, with a total of 1405 implants placed, considering the oncological history of the patients and the implant success rate. The total success rate in the concerned period was 96.65%. When comparing cancer patients with healthy ones, the success rate has been 93.02% in the first case, and 97.16% in the latter. According to the literature review, our results encourage implant placement in cancer patients, it is important to recognize that this is an analysis of a complex care pathway with a large number of confounding variables. However, the findings should not be considered as generalizable.
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Affiliation(s)
| | - Carlos Omaña-Cepeda
- School of Dentistry, Department of Odonto-Stomatology, University of Barcelona Dental Hospital, Barcelona, Spain
| | - Antonio Marí-Roig
- School of Dentistry, Department of Odonto-Stomatology, University of Barcelona Dental Hospital, Barcelona, Spain
| | - José López-López
- School of Dentistry, Department of Odonto-Stomatology, University of Barcelona Dental Hospital, Barcelona, Spain
| | - Enric Jané-Salas
- School of Dentistry, Department of Odonto-Stomatology, University of Barcelona Dental Hospital, Barcelona, Spain
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24
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KARGARNEJAD SAHAND, GHALICHI FARZAN, POURGOL-MOHAMMAD MOHAMMAD, OSKUI IZ, GARAJEI ATA. BIOMECHANICAL EVALUATION OF RECONSTRUCTED EXTENSIVE MANDIBULAR DEFECTS BY DIFFERENT MODELS USING FINITE ELEMENT METHOD. J MECH MED BIOL 2020. [DOI: 10.1142/s0219519420500530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Rehabilitation of major mandibular defects after tumor resection has become a serious challenge for surgeons. In this research, four various models were designed to repair a critical mandibular lateral defect. Biomechanical behavior of the models was assessed by Finite Element Method. These models are including Fibular-Free Flap (FFF), Customized Prosthesis (CP), Tray Implant without Bone Graft (TI-wo-BG), and Tray Implant with Bone Graft (TI-w-BG). FFF is a subset of microvascular free flap technique in which some segments of patient’s fibula bone are used to restore mandibular defects. CP is a hollow and light prosthesis which is fabricated using Additive Manufacturing technology from Ti alloy powder. TI-wo-BG is similar to a crib which is designed according to the geometry of the patient’s mandible. TI-w-BG, in fact, is a TI-wo-BG which is filled with small cortico-cancellous chips in order to benefit potential profit of bone grafting. The chewing operation and loading on the mandible was simulated considering the three mandibular muscular forces including masseter, medial pterygoid, and temporalis. The result of FEM analysis of TI-wo-BG and TI-w-BG showed that in both models, screw number 6 endured a strain of 5684 and 2852[Formula: see text][Formula: see text]m/m which exceeded pathological and mild overload risk, respectively. This may increase the probability of screw loosening and system failure. The results proved the stability of the FFF and CP models. In addition, it can be concluded that stress and strain on the screw’s interfaces can decrease by improving the plate and increasing the friction at the interface of plate, bone and screw.
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Affiliation(s)
- SAHAND KARGARNEJAD
- Faculty of Biomedical Engineering, Sahand University of Technology, P.O. Box: 51335/1996, Sahand New Town, Tabriz, Iran
| | - FARZAN GHALICHI
- Faculty of Biomedical Engineering, Sahand University of Technology, P.O. Box: 51335/1996, Sahand New Town, Tabriz, Iran
| | - MOHAMMAD POURGOL-MOHAMMAD
- Mechanical Engineering Department, Sahand University of Technology, P.O. Box: 51335/1996, Sahand New Town, Tabriz, Iran
| | - I. Z. OSKUI
- Faculty of Biomedical Engineering, Sahand University of Technology, P.O. Box: 51335/1996, Sahand New Town, Tabriz, Iran
| | - ATA GARAJEI
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran, Iran
- The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- The Cancer Institute, Imam Hospital Complex, Keshavarz Blvd., Tehran, Iran
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Goker F, Baj A, Bolzoni AR, Maiorana C, Racco P, Taschieri S, Beretta P, Beltramini G, Gianni AB, Del Fabbro M. Effectiveness of dental implants placed into microvascular free flaps. Oral Dis 2020; 26:1532-1536. [PMID: 32475068 DOI: 10.1111/odi.13451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy
| | - Alessandro Baj
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Alessandro Remigio Bolzoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Pierpaolo Racco
- Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milano, Italy.,Department of Oral Surgery, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Paola Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy
| | - Giada Beltramini
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Aldo Bruno Gianni
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milano, Italy
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Soares PBF, Soares CJ, Limirio PHJO, Lara VC, Moura CCG, Zanetta-Barbosa D. Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant. J Appl Oral Sci 2020; 28:e20200191. [PMID: 32997090 PMCID: PMC7521423 DOI: 10.1590/1678-7757-2020-0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/03/2020] [Indexed: 11/21/2022] Open
Abstract
Objective: This study analyzed the effect of ionizing radiation on bone microarchitecture and biomechanical properties in the bone tissue surrounding a dental implant. Methodology: Twenty rabbits received three dental morse taper junction implants: one in the left tibia and two in the right tibia. The animals were randomized into two groups: the nonirradiated group (control group) and the irradiated group, which received 30 Gy in a single dose 2 weeks after the implant procedure. Four weeks after the implant procedure, the animals were sacrificed, and the implant/bone specimens were used for each experiment. The specimens (n=10) of the right tibia were examined by microcomputed tomography to measure the cortical volume (CtV, mm3), cortical thickness (CtTh, mm) and porosity (CtPo, %). The other specimens (n=10) were examined by dynamic indentation to measure the elastic modulus (E, GPa) and Vickers hardness (VHN, N/mm2) in the bone. The specimens of the left tibia (n=10) were subjected to pull-out tests to calculate the failure load (N), displacement (mm) up to the failure point and interface stiffness (N/mm). In the irradiated group, two measurements were performed: close, at 1 mm surrounding the implant surface, and distant, at 2.5 mm from the external limit of the first measurement. Data were analyzed using one-way ANOVA, Tukey’s test and Student’s t-test (α=0.05). Results: The irradiated bone closer to the implant surface had lower elastic modulus (E), Vickers hardness (VHN), Ct.Th, and Ct.V values and a higher Ct.Po value than the bone distant to the implant (P<0.04). The irradiated bone that was distant from the implant surface had lower E, VHN, and Ct.Th values and a higher Ct.Po value than the nonirradiated bone (P<0.04). The nonirradiated bone had higher failure loads, displacements and stiffness values than the irradiated bone (P<0.02). Conclusion: Ionizing radiation in dental implants resulted in negative effects on the microarchitecture and biomechanical properties of bone tissue, mainly near the surface of the implant.
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Affiliation(s)
| | - Carlos José Soares
- Federal University of Uberlândia, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brasil
| | | | - Vitor Carvalho Lara
- Federal University of Triângulo Mineiro, School of Medicine, Department of Radiology, Uberaba, MG, Brasil
| | | | - Darceny Zanetta-Barbosa
- Federal University of Uberlândia, School of Dentistry, Department of Oral and Maxillofacial Surgery, Uberlândia, MG, Brasil
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Hyperbaric oxygen therapy for the placement of dental implants in irradiated patients: systematic review and meta-analysis. Br J Oral Maxillofac Surg 2020; 59:625-632. [PMID: 33952404 DOI: 10.1016/j.bjoms.2020.08.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/10/2020] [Indexed: 11/20/2022]
Abstract
This study was a systematic review with meta-analysis to evaluate the influence of hyperbaric oxygen therapy (HBOT) on the survival of dental implants placed in patients who had had radiotherapy for cancer of the head and neck. A systematic literature search was conducted using the PubMed/Medline, Science Direct, Embase and the Cochrane Library, between January 1985 and July 2018. The study observed the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) declaration and norms, and the systematic review was duly recorded in the PROSPERO (International prospective register of systematic reviews) database. Inclusion and exclusion criteria were applied, and all articles were selected on the basis of PICO questions. The process of eligibility and quality evaluation yielded three studies for statistical analysis. Based on the survival rates, there was no evidence that the risk of an implant failing was different between the patients who received HBOT and those who did not. Moreover, the risk of an implant failing did not depend on the anatomical site. HBOT exerted no beneficial influence on the survival rates of implants placed in irradiated patients, and the risk of an implant failing did not depend on its location.
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28
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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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Goker F, Baj A, Bolzoni AR, Maiorana C, Giannì AB, Del Fabbro M. Dental implant-based oral rehabilitation in patients reconstructed with free fibula flaps: Clinical study with a follow-up 3 to 6 years. Clin Implant Dent Relat Res 2020; 22:514-522. [PMID: 32578936 DOI: 10.1111/cid.12928] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral rehabilitation of patients after maxillofacial reconstructive surgery represents a challenge and stable prosthetic retention can be achieved with the use of dental implants. PURPOSE This retrospective report aimed to evaluate implant-based oral rehabilitation following maxillofacial reconstruction with free fibula flaps. MATERIALS AND METHODS A total of 14 patients who had reconstruction with fibula flaps either by CAD/CAM or conventional surgery were included in this study. A total of 56 implants (40 in flaps, 16 in native bone) were evaluated. Follow-up after reconstructive surgery ranged between 3.25 and 6.3 years. Follow-up after implant surgery ranged between 1.5 and 3.8 years. RESULTS Overall survival rate was 85.7% in free fibula flaps and 85.6% in dental implants. Eight implants were lost in three patients and all of these failures were in dental implants inserted in free flaps. According to the results on patient basis, the implant survival was not influenced by any variable. CONCLUSIONS The maxillofacial reconstruction with free fibula flap and oral rehabilitation with implant-supported prostheses after ablative surgery can be considered as an effective and safe procedure with successful aesthetic and functional outcomes.
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Affiliation(s)
- Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy
| | - Alessandro Baj
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Alessandro Remigio Bolzoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Aldo Bruno Giannì
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,Dental and Maxillo-Facial Surgery Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
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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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Rehabilitation after maxillectomy in patients with implant-retained obturator: A preliminary report. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:8-13. [PMID: 31562033 DOI: 10.1016/j.oooo.2019.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/19/2019] [Accepted: 08/26/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical outcomes of implant-retained obturator rehabilitation after maxillectomy, based on quality of life (QOL) and masticatory function. STUDY DESIGN The present study included 12 patients who underwent dental implant surgery after maxillectomy. Oral health-related QOL and masticatory function before and after completion of implant-retained obturator rehabilitation were evaluated. RESULTS Oral Health Impact Profile-Short Form (OHIP-14) scores showed significant differences in the domain for functional limitation (before, 4.08 ± 2.47; after, 1.33 ± 0.98; P < .01); physical pain (before, 2.75 ± 2.05; after, 0.42 ± 0.51; P < .01); physical disability (before, 3.24 ± 2.11; after, 1.33 ± 1.30; P < .01), psychological disability (before, 3.83 ± 2.48; after, 1.67 ± 2.50; P < .01); social disability (before, 2.17 ± 1.75; after, 1.08 ± 1.38; P < .05); handicap (before, 3.17 ± 1.90; after, 1.08 ± 1.00; P < .01); and total score (before, 22.41 ± 10.17; after, 8.83 ± 6.82; P < .01) Furthermore, masticatory function score was significantly higher after completing implant-retained obturator rehabilitation (before, 38.75 ± 22.97; after, 69.17 ± 21.41; P < .01). CONCLUSIONS Implant-retained obturator rehabilitation contributed to improved masticatory function and oral health-related QOL after maxillectomy.
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Use of Porous Implants for the Prosthetic Rehabilitation of Fibula Free Flap Reconstructed Patients. J Craniofac Surg 2019; 30:1163-1169. [PMID: 31166262 DOI: 10.1097/scs.0000000000005218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Vascularized free flaps represent today the gold standard in Maxillo-Facial reconstructive treatment of the upper and lower compromised maxillas.The aim of this study is to perform the advantages and disadvantages of the vascularized fibula free flap and the available rehabilitation options with porous implants.In this study the authors analyzed 45 patients with 211 inserted implants treated and reconstructed with vascularized fibula flaps. The authors compared the use of 103 titanium tapered implants (with micro rough surface) versus 108 tantalum-titanium porous implants to evaluate the bone reabsorption and implant survival. Immediate implant stability, the peri-implant reabsorption, and the survival were evaluated. The follow-up was after 3, 6, 12, and 24 months.The authors found that for the 108 Zimmer TM they had an average bone loss of 1 mm ± 0.2 mm after 1 year of follow-up, compared with the other implants where the average bone loss was 2.27 mm ± 0.4.This study demonstrated that the problems caused by different fibula flaps level, compared with the mandibula or, with adjacent teeth in the maxilla, can be solved using TM porous implants that almost duplicate the fixture surface and guarantees long life prognosis to the authors' prosthetic devices.
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Systemic and local effects of radiotherapy: an experimental study on implants placed in rats. Clin Oral Investig 2019; 24:785-797. [PMID: 31154539 DOI: 10.1007/s00784-019-02946-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 05/03/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Evaluate the modulating effect of ionizing radiation, blood cytokine levels, and bone remodeling of the interface around the implant to understand the radiation mechanisms which can impair the implants receptor site. MATERIAL AND METHODS Sixty rats were submitted to grade V titanium implants in the femurs and were divided into the following groups: no-irradiation (N-Ir): control group with implant only; early-irradiation (E-Ir): implant + irradiation after 24 h; late-irradiation (L-Ir): implant + irradiation after 4 weeks; and previous-irradiation (P-Ir): irradiation + implant after 4 weeks. The animals in the E-Ir, L-Ir, and P-Ir groups were irradiated in two fractional stages of 15 Gy. At 3 days, 2 weeks, and 7 weeks after the final procedure, five animals were randomly euthanized per group. Serum levels of TNF-ɑ, IL-1β, TGF-β, IL-6, M-CSF, and IL-10 were measured from blood collected prior to euthanasia using the ELISA test. The pieces containing the implants were subjected to immunohistochemical labeling using the tartrate acid resistant to phosphatase, osteocalcin, and caspase-3 markers and mCT. The ANOVA test was used for statistical analysis, and the Tukey multiple comparison test (p < 0.05) was applied. RESULTS The results indicated that ionizing radiation modifies the production of pro- and anti-inflammatory serum cytokines, the expression of proteins involved in bone remodeling and cellular apoptosis, as well as changes in bone formation. CONCLUSIONS The results suggests that a longer period between radiotherapy and implant placement surgery when irradiation occurs prior to implant installation would allow the recovery and renewal of bone cells and avoid future failures in osseointegration. CLINICAL RELEVANCE The search for modifications caused by ionizing irradiation in bone tissue can indicate the ideal period for implant placement without affecting the osseointegration process.
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34
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Papi P, Brauner E, Di Carlo S, Musio D, Tombolini M, De Angelis F, Valentini V, Tombolini V, Polimeni A, Pompa G. Crestal bone loss around dental implants placed in head and neck cancer patients treated with different radiotherapy techniques: a prospective cohort study. Int J Oral Maxillofac Surg 2019; 48:691-696. [DOI: 10.1016/j.ijom.2018.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 09/19/2018] [Accepted: 10/29/2018] [Indexed: 10/27/2022]
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35
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Soares PBF, Soares CJ, Limirio PHJO, de Jesus RNR, Dechichi P, Spin-Neto R, Zanetta-Barbosa D. Effect of ionizing radiation after-therapy interval on bone: histomorphometric and biomechanical characteristics. Clin Oral Investig 2018; 23:2785-2793. [PMID: 30368663 DOI: 10.1007/s00784-018-2724-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/18/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effects of radiotherapy on biomechanical, histomorphometric, and microstructural characteristics of bone, in diverse periods, compared with intact bone tissue. MATERIALS AND METHODS Eighteen adult male New Zealand rabbits were treated with a single radiation dose of 30 Gy. The animals were randomly divided into six groups: NoIr, control group, no radiation, and five irradiated groups sacrificed after 24 h (Ir24h), 7 (Ir7d), 14 (Ir14d), 21 (Ir21d), and 28 (Ir28d) days. After these periods, the animals were sacrificed and their tibias (n = 6) evaluated using three-point bending test to calculate the ultimate force, work to failure, and bone stiffness. Dynamic indentation test was used to quantify Vickers hardness and elasticity modulus of bone tissue. Micro-CT was used to analyze the cortical volume (CtV), cortical thickness (CtTh), and porosity (Ct.Po). Histomorphometric assessment was based on the lacunarity of bone tissue. Data were analyzed using one-way ANOVA and Kruskal-Wallis tests followed by Tukey, Dunnet, and Dunn's post-tests (P < 0.05). RESULTS The ultimate force, work to failure, stiffness, elastic modulus, and Vickers hardness values of irradiated bone were significantly lower that non-irradiated bone. Irradiated bone showed significantly lower CtTh and CtV values and higher CtPo than non-irradiated bone. No significant difference was found for lacunarity between non-irradiated bone and irradiated bone. CONCLUSIONS Ionizing radiation decreases normal anisotropy on microarchitecture of cortical bone, and increases bone fragility compared with non-irradiated bone. Further, these changes were seen after longer periods (e.g., 14 and 21 days), and not immediately after radiation therapy. CLINICAL RELEVANCE The radiotherapy reduces bone mechanical properties and the normal structure of organic and inorganic bone matrix. For studying the protocols to protect the radiotherapy effect using rabbit model, the use of the sacrificing period between 14 and 21 days is recommended.
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Affiliation(s)
- Priscilla Barbosa Ferreira Soares
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil.
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
| | - Pedro Henrique Justino Oliveira Limirio
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
| | - Rainde Naiara Rezende de Jesus
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4T, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
| | - Paula Dechichi
- Institute of Biomedical Sciences, Federal University of Uberlândia, Avenida Pará 1720, Campus Umuarama, Bloco 2B, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Department of Oral Radiology, Aarhus University, Vennelyst Boulevard 9, Building 1613, 130, 8000, Aarhus C, Denmark
| | - Darceny Zanetta-Barbosa
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4T, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
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36
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Schimmel M, Srinivasan M, McKenna G, Müller F. Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:311-330. [DOI: 10.1111/clr.13288] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Martin Schimmel
- Division of GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
| | - Gerald McKenna
- Centre for Public HealthQueen's University Belfast Institute of Clinical Sciences Belfast UK
| | - Frauke Müller
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
- Department of Internal Medicine, Rehabilitation and GeriatricsUniversity Hospitals of Geneva Thônex Switzerland
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Jumeau R, Nguyen-Tan PF, Bahig H, Liem X, Lambert L, Schmittbuhl M, Simard D, Filion E. Pre-irradiation dental care: Ready-to-use templates for oropharyngeal cancers. Rep Pract Oncol Radiother 2018; 23:270-275. [PMID: 30090026 DOI: 10.1016/j.rpor.2018.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/02/2018] [Accepted: 06/23/2018] [Indexed: 11/30/2022] Open
Abstract
Aim To develop a tool in order to guide pre-irradiation dental care (PIDC) for patients with oropharyngeal cancers. Background Osteoradionecrosis of the jaws is a potential complication of radiotherapy (RT) for head and neck cancers. To prevent this complication, PIDC can involve multiple dental extractions as a preventative measure to avoid post-RT complications. However, there is no standardized tool to guide PIDC. Materials and methods From January 2005 to October 2015, 120 head and neck cancer patients were prospectively included in a study investigating dysgeusia after RT. From this cohort, patients were enrolled according to the following inclusion criteria: histopathological confirmation of oropharyngeal squamous cell carcinoma; stage T1-4 N1-3 M0; ≤10 missing teeth. Individual teeth were retrospectively delineated on planning computed tomography and doses to dentition were assessed to generate templates. Results Thirty-three patients were included. Molars received highest doses with a mean dose of 50 Gy (range; 19-75 Gy). Ipsi-lateral and contralateral wisdom teeth received RT dose superior to 50 Gy in 92% and 56% of cases, respectively. Patients with advanced disease (T4 or N2c-3) received higher mean doses on inferior and ipsi-lateral dental arches compared to other patients (T1-3 N0-2b): 42 Gy vs. 39 Gy and 44 Gy vs. 39 Gy (p < 0.05), respectively. Conclusion Pre-RT dose distribution templates are an objective way to prepare PIDC. Further studies with a larger cohort are needed to validate these templates.
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Affiliation(s)
- Raphaël Jumeau
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Phuc Félix Nguyen-Tan
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Houda Bahig
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Xavier Liem
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Louise Lambert
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Matthieu Schmittbuhl
- Faculty of Dentistry, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Dany Simard
- Department of Radiation Physics, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Edith Filion
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
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Petrovic I, Rosen EB, Matros E, Huryn JM, Shah JP. Oral rehabilitation of the cancer patient: A formidable challenge. J Surg Oncol 2018; 117:1729-1735. [PMID: 29723421 PMCID: PMC6135661 DOI: 10.1002/jso.25075] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 02/03/2023]
Abstract
Rehabilitation of oral functions following surgery on the jaws is a goal that is often difficult to achieve. Removable dentures supported by remaining teeth or gum are often unstable and seldom satisfactory. On the other hand, endosseous (dental) implants offer a mechanism to provide stability to the dentures. This review, discusses factors related to the tumor, patient, treatment, and physicians which impact upon the feasibility and success of dental implants in patients with oral cancer.
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Affiliation(s)
- Ivana Petrovic
- Straumann Maxillofacial Dental Implantology Research Fellow, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Evan B Rosen
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Evan Matros
- Plastic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joseph M Huryn
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jatin P Shah
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Curi M, Condezo A, Ribeiro K, Cardoso C. Long-term success of dental implants in patients with head and neck cancer after radiation therapy. Int J Oral Maxillofac Surg 2018; 47:783-788. [DOI: 10.1016/j.ijom.2018.01.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/05/2017] [Accepted: 01/17/2018] [Indexed: 11/17/2022]
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Aboushelib MN, Arnaout MA, Elsafi MH, Kassem YM. Two-stage implant placement technique for the management of irradiated jaws: An animal study. J Prosthet Dent 2017; 118:546-550. [PMID: 28343674 DOI: 10.1016/j.prosdent.2017.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/24/2017] [Accepted: 01/24/2017] [Indexed: 11/28/2022]
Abstract
STATEMENT OF PROBLEM Radiotherapy results in diminished bone remodeling capacity and an elevated risk of osteoradionecrosis, which can negatively influence the survival rate of dental implants. Patients receiving radiotherapy are advised not to receive dental implants during or soon after completing their radiotherapy. PURPOSE The purpose of this animal study was to investigate a 2-stage implant placement technique designed to diminish applied trauma on irradiated bone. MATERIAL AND METHODS Two groups of white New Zealand rabbits received radiotherapy in ascending doses (2, 4, 8 Gy), while a nonirradiated group served as control. Three weeks after completion of the last radiotherapy session, one of the irradiated groups and the control group received titanium dental implants bilaterally in the femur head. For the second irradiated group, an osteotomy was performed, and the surgical wound was left to heal for 2 weeks before implant placement. All animals were sacrificed 4 weeks after implant placement, and histomorphometric analysis was used to study bone-implant contact (n=14, α=.05). RESULTS Statistical analysis revealed significantly higher (F=159, P<.001) bone-implant contact in the 2-stage (40.2 ±1.9) implant placement technique than in the immediately placed implants (21.2 ±2.3) in irradiated bone. Both of the groups had a significantly lower bone-to-implant contact ratio than the non-irradiated control (64.2 ±3.8). CONCLUSIONS Within the limitations of this animal study, the 2-stage implant placement technique could be used to reduce trauma in irradiated bone and to improve wound healing around dental implants.
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Affiliation(s)
- Moustafa N Aboushelib
- Associate Professor, Department of Dental Materials, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Mohamed A Arnaout
- Lecturer, Department of Conservative and Prosthetic Dentistry, School of Dentistry, College of Health Science, Moi University, Eldoret, Kenya
| | - Mohamed H Elsafi
- Researcher, Fine Measurement Lab, Department of Dental Material, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Youssef M Kassem
- Demonstrator, Department of Dental Materials, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Maxillofacial Prosthesis in Dentofacial Traumas: A Retrospective Clinical Study and Introduction of New Classification Method. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8136878. [PMID: 28337459 PMCID: PMC5350426 DOI: 10.1155/2017/8136878] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 01/11/2017] [Accepted: 02/06/2017] [Indexed: 11/29/2022]
Abstract
Background. Maxillofacial trauma represents a field of common interest as regards both the maxillofacial surgery and prosthodontics, especially for the functional and aesthetic stomatognathic rehabilitation. This condition necessitates relationship between maxillofacial surgeon and prosthodontist, to achieve the ultimate treatment goal. Purpose. The purpose of this study is to make predictable patients outcomes classifying their clinical data, using certain parameters and introducing a new classification method. Materials and Methods. We have chosen 7 parameters to classify the entity of the damage of these patients and to make their treatment and their prognosis predictable: number of teeth lost (T1–T4), upper/lower maxilla (U/L), alveolar/basal bone (Alv/B), gingival tissues (G), soft tissues (S), adult/child (a/c), and reconstructed patient (R). Results and Conclusions. The multidisciplinary approach and the collaboration between multiple clinical figures are therefore critical for the success of the treatment of these patients. The presence and quantification of above parameters influence the treatment protocol; patients undergo different levels of treatment depending on the measured data. The recognition of certain clinical parameters is fundamental to frame diagnosis and successful treatment planning.
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Postradiotherapy Dental Implant Insertion Into Bone Grafts Harvested From Nonirradiated Tissue: Case Reports. IMPLANT DENT 2016; 25:715-9. [PMID: 27540844 DOI: 10.1097/id.0000000000000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prostheses and dental implants are often used to aid oral rehabilitation after surgery (with/without radiotherapy) for oral cancer. However, some studies have reported that the insertion of dental implants into irradiated bone results in a higher frequency of implant failure than the insertion of such implants in nonirradiated bone. MATERIALS AND METHODS This report describes the cases of 4 patients with oral cancer who underwent surgery and radiotherapy (total dose: 50-86 Gy) and then had dental implants inserted within the irradiated area. In each case, an ilium bone graft or a latissimus dorsi myocutaneous flap containing scapular bone was transferred to the dental implant site before the insertion of the implants. RESULTS Twenty-three implants were inserted. After loading, 2 implants were lost, and 21 remained stable. CONCLUSION In patients who have undergone radiotherapy for oral cancer, transferring bone grafts harvested from nonirradiated tissue to the irradiated site before implant insertion might help to improve dental implant survival rates.
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Seregin SS. [On the question of dental implantation follow-up and results assessment in patients with risk factors]. STOMATOLOGII︠A︡ 2016; 95:73-76. [PMID: 27182565 DOI: 10.17116/stomat201695173-76] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- S S Seregin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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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.
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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
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