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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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Lv Z, Wu K, Qin X, Yuan J, Yan M, Zhang J, Wang L, Ji T, Cao W, Chen W. A Novel Tumor Suppressor SPINK5 Serves as an Independent Prognostic Predictor for Patients with Head and Neck Squamous Cell Carcinoma. Cancer Manag Res 2020; 12:4855-4869. [PMID: 32606974 PMCID: PMC7320891 DOI: 10.2147/cmar.s236266] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 04/25/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In our previous study, serine protease inhibitor Kazal-type 5 (SPINK5), which encodes the product of serine protease inhibitor lymphoepithelial Kazal-type-related inhibitor (LEKTI) was found to be down-regulated in head and neck squamous cell carcinoma (HNSCC) using oligonucleotide microarrays. However, the function and clinical implications of SPINK5/LEKTI remain obscure in HNSCC. METHODS The endogenous expression level of SPINK5/LEKTI was further verified in 9 HNSCC cell lines and HNSCCs by means of reverse transcription-polymerase chain reaction, real-time PCR, Western blotting and immunohistochemistry. The biological function of SPINK5/LEKTI was investigated in vitro and in vivo experiments. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to determine the correlation between SPINK5/LEKTI expression and clinical outcome. RESULTS Down-regulation expression of SPINK5/LEKTI was found in six out of nine HNSCC cell lines and in 85.7% HNSCC specimens (P<0.0001). Upon silencing of SPINK5/LEKTI, the cell proliferation, plate colony formation and cell invasion of WU-HN6 cells were significantly increased, while exogenous overexpression of SPINK5/LEKTI, the proliferation, plate colony and invasion of WU-HN13 and HN30 cells were remarkably inhibited with the arrest of G1 cell cycle (P=0.0001, P=0.003, respectively). HNSCC patients with lower LEKTI levels had significantly inferior overall survival compared to those patients with higher LEKTI (P=0.0017) by Kaplan-Meier survival analysis. Univariate and multivariate Cox proportional hazards regression model analysis revealed that LEKTI expression was an independent prognostic predictor for HNSCC patients (HR=0.114, 95% CI:0.044-0.292, P<0.001). CONCLUSION Our results demonstrate that SPINK5/LEKTI might be a tumor suppressor in HNSCCs and serve as an independent prognostic predictor for HNSCC patients.
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Affiliation(s)
- Zhongjing Lv
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Stomatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou City, Jiangsu Province, People’s Republic of China
| | - Kun Wu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China
| | - Xing Qin
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China
| | - Jian Yuan
- Department of Stomatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou City, Jiangsu Province, People’s Republic of China
| | - Ming Yan
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China
| | - Jianjun Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China
| | - Lizhen Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Oral Pathology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Tong Ji
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China
| | - Wei Cao
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China
| | - Wantao Chen
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China
- Correspondence: Wantao Chen; Wei Cao Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China Email ;
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Zhang X, Li H, Li Q, Li Y, Li C, Zhu M, Zhao B, Li G. Application of red light phototherapy in the treatment of radioactive dermatitis in patients with head and neck cancer. World J Surg Oncol 2018; 16:222. [PMID: 30419911 PMCID: PMC6233368 DOI: 10.1186/s12957-018-1522-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/29/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To observe the effect of red light phototherapy (RLPT) on radioactive dermatitis (RD) caused by radiotherapy in patients with head and neck cancer (HNC). METHODS Sixty patients with HNC admitted to our hospital were randomly divided into experimental group and control group, 30 patients in each group. The control group received routine daily care during radiotherapy treatment. In the experimental group, in addition to routine daily care during radiotherapy treatment, photon therapy apparatus RLPT was added, 10 min/time, 2 times/day, and lasted until the end of radiotherapy. The pain and conditions of the patients' skin were assessed daily, and the skin pain and dermatitis grades of the two groups were compared. RESULTS In terms of the reaction degree of RD, experimental group was mainly grade 0-2, and control group was mainly grade 2-3, with a significant difference (P < 0.05). In terms of skin pain, according to the pain records at week 2, 3, and 4, the pain degree increased with time. However, the score of wound pain in experimental group was significantly lower than that in control group, and there was a significant difference between the two groups (P < 0.05). CONCLUSIONS The application of RLPT in the treatment of RD can help accelerate wound healing and significantly shorten healing time. It can not only reduce wounds pain of patients, promote inflammation and ulcer healing, but also ensure the smooth progress of patients' radiotherapy and improve their quality of lives, which is worth popularization and application in the clinical practice.
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Affiliation(s)
- Xudong Zhang
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Hongfei Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Qian Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Ying Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Chao Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Minmin Zhu
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Bing Zhao
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Guowen Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
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Flores-Ruiz R, Castellanos-Cosano L, Serrera-Figallo MA, Cano-Díaz E, Torres-Lagares D, Gutiérrez-Pérez JL. Implant survival in patients with oral cancer: A 5-year follow-up. J Clin Exp Dent 2018; 10:e603-e609. [PMID: 29930780 PMCID: PMC6005093 DOI: 10.4317/jced.54937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/26/2018] [Indexed: 01/03/2023] Open
Abstract
Background To evaluate the evolution of patients rehabilitated with endosseous implants after oral cancer treatment. Material and Methods An observational retrospective study was carried out between 1991 and 2011 with a sample consisting of patients with oral cancer who had been referred for rehabilitation to the Prosthetics Rehabilitation Unit from the Oral and Maxillofacial Surgery Unit of the Virgen del Rocío University Hospital. All these patients have overcome oral cancer, and have a five-year follow-up after their oral rehabilitation. Age, sex, smoking habits, oral pathology, type of treatment of oral pathology, edentulism, receptor bone, prosthetic rehabilitation, timeouts, working time and evolution were studied. SPSS Statistics was used for statistical analysis of the variables studied. A chi-square test centered on the survival rate of implants placed in relation to the other recorded variables was performed. Results 17 patients were treated for cancer and rehabilitated with implant prosthetics, with a total of 106 implants placed. 32% were partially edentulous patients (4 patients), and 68.2% were completely edentulous patients (13 patients). An implant survival rate of 87.7% was observed at 5 years. In the upper maxilla, the survival rate was 79.2%, and in the mandible 93.7% (p = 0.03). 91 implants were placed in native receptor bones (85.8%), with only 15 implants placed in grafted receptor bone (14.2%). According to the type of receptor bone, in native receptor bones, 9 implants failed (90.1% of implant survival), while in grafted receptor bones, 4 implants failed (overall 73.3% implant survival rate) (p = 0.08). Conclusions Although a high survival rate was obtained in this study (with lower survival rates seen in mandible and grafted bone), prospective long-term studies are needed to assess the relationship between radiotherapy doses and the time required for implant placement, prosthetic protocol used, and type of implants used in patients selected for prosthetic rehabilitation. Key words:Dental implant, oral cancer, survival.
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Affiliation(s)
| | | | | | - Eloy Cano-Díaz
- Department of Stomatology, School of Dentistry, University of Seville
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Brett E, Flacco J, Blackshear C, Longaker MT, Wan DC. Biomimetics of Bone Implants: The Regenerative Road. Biores Open Access 2017; 6:1-6. [PMID: 28163982 PMCID: PMC5248549 DOI: 10.1089/biores.2016.0044] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The current strategies for healing bone defects are numerous and varied. At the core of each bone healing therapy is a biomimetic mechanism, which works to enhance bone growth. These range from porous scaffolds, bone mineral usage, collagen, and glycosaminoglycan substitutes to transplanted cell populations. Bone defects face a range of difficulty in their healing, given the composite of dense outer compact bone and blood-rich inner trabecular bone. As such, the tissue possesses a number of inherent characteristics, which may be clinically harnessed as promoters of bone healing. These include mechanical characteristics, mineral composition, native collagen content, and cellular fraction of bone. This review charts multiple biomimetic strategies to help heal bony defects in large and small osseous injury sites, with a special focus on cell transplantation.
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Affiliation(s)
- Elizabeth Brett
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
| | - John Flacco
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
| | - Charles Blackshear
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
| | - Michael T Longaker
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine, Stanford, California.; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California
| | - Derrick C Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
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Abstract
Several systemic diseases (and relative medications) have been reported to impair or in some cases complicate dental implant surgery. In broader terms, when dealing with patients suffering from systemic diseases, the monitoring of the medical condition and of the related post-operative complications is of great importance in order to avoid risks which could jeopardise the health of the patient. In this review, the available evidence on implant survival/success, as well as relevant surgical recommendations in patients affected by systemic diseases, are evaluated and when possible, practical suggestions for the clinician are provided.
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Offermanns V, Andersen OZ, Riede G, Andersen IH, Almtoft KP, Sørensen S, Sillassen M, Jeppesen CS, Rasse M, Foss M, Kloss F. Bone regenerating effect of surface-functionalized titanium implants with sustained-release characteristics of strontium in ovariectomized rats. Int J Nanomedicine 2016; 11:2431-42. [PMID: 27313456 PMCID: PMC4892864 DOI: 10.2147/ijn.s101673] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Since strontium (Sr) is known for its anabolic and anticatabolic effect on bone, research has been focused on its potential impact on osseointegration. The objective of this study was to investigate the performance of nanotopographic implants with a Sr-functionalized titanium (Ti) coating (Ti–Sr–O) with respect to osseointegration in osteoporotic bone. The trial was designed to examine the effect of sustained-release characteristics of Sr in poor-quality bone. Three Ti–Sr–O groups, which differed from each other in coating thickness, Sr contents, and Sr release, were examined. These were prepared by a magnetron sputtering process and compared to uncoated grade 4 Ti. Composition, morphology, and mechanical stability of the coatings were analyzed, and Sr release data were gained from in vitro washout experiments. In vivo investigation was carried out in an osteoporotic rat model and analyzed histologically, 6 weeks and 12 weeks after implantation. Median values of bone-to-implant contact and new bone formation after 6 weeks were found to be 84.7% and 54.9% (best performing Sr group) as compared to 65.2% and 23.8% (grade 4 Ti reference), respectively. The 12-week observation period revealed 84.3% and 56.5% (best performing Sr group) and 81.3% and 39.4% (grade 4 Ti reference), respectively, for the same measurements. The increase in new bone formation was found to correlate with the amount of Sr released in vitro. The results indicate that sputtered nanostructured Ti–Sr–O coatings showed sustained release of Sr and accelerate osseointegration even in poor-quality bone, and thus, may have impact on practical applications for medical implants.
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Affiliation(s)
- Vincent Offermanns
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Ole Zoffmann Andersen
- Interdisciplinary Nanoscience Center (iNANO), Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
| | - Gregor Riede
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University Innsbruck, Innsbruck, Austria
| | | | | | - Søren Sørensen
- Tribology Centre, Danish Technological Institute, Aarhus, Denmark
| | - Michael Sillassen
- Interdisciplinary Nanoscience Center (iNANO), Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
| | | | - Michael Rasse
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Morten Foss
- Interdisciplinary Nanoscience Center (iNANO), Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
| | - Frank Kloss
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University Innsbruck, Innsbruck, Austria
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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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Radiation-induced caries as the late effect of radiation therapy in the head and neck region. Contemp Oncol (Pozn) 2015; 20:287-90. [PMID: 27688724 PMCID: PMC5032152 DOI: 10.5114/wo.2015.54081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/07/2015] [Indexed: 11/26/2022] Open
Abstract
Overall improvement in the nationwide system of medical services has consequently boosted the number of successfully treated patients who suffer from head and neck cancer. It is essential to effectively prevent development of radiation-induced caries as the late effect of radiation therapy. Incidence and severity of radiationinduced changes within the teeth individually vary depending on the patient's age, actual radiation dose, size of radiation exposure field, patient's general condition and additional risk factors. Inadequately managed treatment of caries may lead to loss of teeth, as well as prove instrumental in tangibly diminishing individual quality of life in patients. Furthermore, the need to have the teeth deemed unyielding or unsuitable for the application of conservative methods of treatment duly extracted is fraught for a patient with an extra hazard of developing osteoradionecrosis (ORN), while also increasing all attendant therapeutic expenditures. The present paper aims to offer some practical insights into currently available methods of preventing likely development of radiation-induced caries.
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Pompa G, Saccucci M, Di Carlo G, Brauner E, Valentini V, Di Carlo S, Gentile T, Guarino G, Polimeni A. Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study. BMC Oral Health 2015; 15:5. [PMID: 25599761 PMCID: PMC4324417 DOI: 10.1186/1472-6831-15-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 01/14/2015] [Indexed: 11/18/2022] Open
Abstract
Background The aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy. Methods We collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone. Results Implant loss was dependent on the position and location of the implants (P = 0.05–0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determining survival. We observed significantly better outcomes when the implant was not loaded until at least 6 months after placement. Conclusions Although the retrospective design of this study could be affected by selection and information biases, we conclude that a delayed loading protocol will give the best chance of implant osseointegration, stability and, ultimately, effective dental rehabilitation.
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Affiliation(s)
| | - Matteo Saccucci
- Department of Oral and Maxillofacial Science, Sapienza University of Rome, Via Caserta 272/A, Rome, Italy.
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