Assessment of prosthetic restorations on bone-lock implants in patients after oral tumor resection

Clinical performance of different types of dental prosthesis in patients with head and neck tumors-a retrospective cohort study

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.

Combined Implant and Tooth Support: An Up-to-Date Comprehensive Overview

Objectives. This article presents a review on the concerned topics and some considerations related to the concept of splinting teeth and implants in the rehabilitation of partial edentulism. Study Selection. An electronic PubMed/MEDLINE and manual search of identified articles and reviews as well as clinical, laboratory, and finite element studies was performed in this project. Due to the shortage in within-subject, long term, randomized, controlled clinical trials regarding the subject a meta-analysis was not possible. Results. Although surrounded with some controversy, joining teeth and implants during the rehabilitation of partial edentulism provides the clinicians with more treatment options where proprioception and bone volume are maintained and distal cantilevers and free end saddles are eliminated. It makes the treatment less complex, of less cost, and more acceptable for the patient. Conclusions. Whenever suitable and justified, combining implant and tooth support might be recommended as an alternative during rehabilitation of partial edentulism. Based on the literature, clinical tips and suggestions were recommended to increase the success of this treatment.

Complete oral rehabilitation of a postresection ameloblastoma patient: a clinical case report

Conventional ameloblastomas are rare, benign, epithelial odontogenic tumors that tend to grow slowly in the mandible or maxilla, but are locally invasive and can be highly destructive of the surrounding dental anatomy. Aggressive resection is the most effective method of eliminating the tumors, but treatment can further contribute to patient deformity and malfunction. Ameloblastomas also have a high rate of recurrence, which significantly diminishes 8 years after resection, but still requires vigilant clinical monitoring. This case report describes the complete oral rehabilitation of a postresection ameloblastoma patient with a mandibular reconstruction plate and partial edentulism. An autogenous graft was taken from the patient's iliac crest, shaped to fit the defect, and attached with bone screws. After graft incorporation, dental implants were successfully placed into the augmented ridge and restored with a fixed partial denture. There was no evidence of tumor recurrence during the 10 months of treatment or 8 years of subsequent clinical monitoring.

Comparison of early telescope loading of non-submerged ITI implants in irradiated and non-irradiated oral cancer patients

OBJECTIVE

To compare early dental implant loading in irradiated and non-irradiated oral cancer patients in order to accelerate masticatory function improvement and quality of life.

PATIENTS AND METHODS

One hundred and fourteen non-submerged interforaminal ITI implants were early loaded in 30 patients after 3 weeks in situ (telescoped overdenture). Nineteen patients received 72 implants (63%) after local irradiation; 11 non-irradiated patients received 42 implants (37%) with a 24-month follow-up.

RESULTS

At 24 month follow-up, one early failure had occurred in an irradiated patient (=99% functioning implants in situ). Peri-implant bleeding and plaque index were similarly high in both groups (40 to 68% average). The Results of other measured parameters were as follows (values for mean; irradiated; non-irradiated patients with respective standard deviations; significance of comparison): bone loss (0.9+/-0.9; 1.4+/-0.9; 0.4+/-0.5 mM; P<0.01); Periotest score (-2.7+/-2.7; -2.4+/-2.2; -3.1+/-3.3; P<0.2); gingival recession (0.6+/-0.7 mM; 0.8+/-0.9 mM; 0.4+/-0.5 mM, P<0.02); and peri-implant probing depths (3+/-1.2; 2.6+/-0.6; 3.4+/-1.7 mM; P<0.002).

CONCLUSION

The results suggest reliable non-submerged implantation and early loading. However, bone loss in irradiated mandibles, combined with higher average Periotest values and gingival recession in an oral environment of altered saliva quantity, quality, microflora and local scarring, requires extended follow-up.

Effective health care: management of head and neck cancers

The management of head and neck cancer, published in a recent issue of Effective Health Care, is reviewed.

ITI implants and Dolder bars in the treatment of large traumatic defect of mandible: a clinical report

The development of more sophisticated implant techniques to produce satisfying results improves the precise planning of both the surgical phase of the implantation and the following prosthetic rehabilitation. Ball and bar attachments are the main retainer systems for implant-bearing overdentures to achieve a successful treatment in the partial or full edentulism. In this clinical report, a 23-year-old male patient, presented with a large traumatic defect in the anterior mandible, was treated with ITI implant and ITI Dolder bar combinations. The reason to prefer this kind of treatment depends on the highest retention capacity and cleaning facilities of the system.