The key to success: maintaining the long-term health of implants

During the infancy years of dental implantology, the emphasis for long-term success of osseointegrated implants was the surgical phase of dental implantology. In the years that followed, the emphasis for success had switched from a purely surgical influence to focusing more on the proper fixture placement which would be dictated by the prosthetic and aesthetic needs of each particular case. In more recent years, the dental profession has recognized professional implant maintenance and diligent patient home care as two critical factors for the long-term success of dental implants. The microbiota and clinical presentation of peri-implantitis is the same as periodontitis around a natural tooth.

Osseointegrated implants in the head and neck cancer patient

BACKGROUND

Osseointegrated implants allow patients with oromandibular defects to obtain complete or partial dentition via implant-assisted or implant-borne prostheses. Implants restore masticatory and occlusal function, improving oral intake and articulation. However, use of implants in head and neck cancer patients has been discouraged due to lack of data supporting their utility in these patients. This study attempts to establish the validity of using osseointegrated implants for dental restoration in head and neck cancer patients.

METHODS

Six patients who underwent resection/reconstruction for head and neck cancer received osseointegrated implants. Integration was assessed clinically, radiographically, and mechanically at 4-8 months; oral intake, mastication, and articulation were evaluated 6-12 months after receiving the dental prosthesis.

RESULTS

Osseointegration occurred in 92% (24/26) of the implants: 100% (14/14) in neomandibles and 83% (10/12) in native mandibles. One patient had implants (2/5) that failed to integrate. The remaining patients' implants were immobile, free of infection, with no osteoradionecrosis. These patients tolerated a regular diet and experienced weight gain and improved articulation.

CONCLUSIONS

The advent of osseointegrated implants and their compatibility with native and neomandible allows the restoration of functional dentition in patients undergoing ablative surgery for head and neck cancer.

Osseointegrated implants in the head and neck cancer patient

BACKGROUND

Osseointegrated implants allow patients with oromandibular defects to obtain complete or partial dentition via implant-assisted or implant-borne prostheses. Implants restore masticatory and occlusal function, improving oral intake and articulation. However, use of implants in head and neck cancer patients has been discouraged due to lack of data supporting their utility in these patients. This study attempts to establish the validity of using osseointegrated implants for dental restoration in head and neck cancer patients.

METHODS

Six patients who underwent resection/reconstruction for head and neck cancer received osseointegrated implants. Integration was assessed clinically, radiographically, and mechanically at 4-8 months; oral intake, mastication, and articulation were evaluated 6-12 months after receiving the dental prosthesis.

RESULTS

Osseointegration occurred in 92% (24/26) of the implants: 100% (14/14) in neomandibles and 83% (10/12) in native mandibles. One patient had implants (2/5) that failed to integrate. The remaining patients' implants were immobile, free of infection, with no osteoradionecrosis. These patients tolerated a regular diet and experienced weight gain and improved articulation.

CONCLUSIONS

The advent of osseointegrated implants and their compatibility with native and neomandible allows the restoration of functional dentition in patients undergoing ablative surgery for head and neck cancer.

Using cross-sectional tomography to perform exploratory radiography in lieu of exploratory surgery

Preoperative treatment planning for dental implants is crucial to their integration and especially prosthetic rehabilitation. Exploratory radiography is an essential component of treatment planning. Radiographic examination using cross-sectional tomography as an adjunct to panoramic radiographs can significantly decrease the incidence of exploratory surgery that could result in unplanned bone augmentation procedures due to insufficiency in alveolar bone height, width, quantity, quality, and will not allow proper aesthetic prosthetic rehabilitation subsequent to improper implant placement.

Fecal carriage of Streptococcus bovis and colorectal adenomas

An association between fecal carriage of Streptococcus bovis and colorectal carcinoma has been reported. A relationship between S. bovis and colorectal adenomas has also been suggested. In the present study, the relationship between S. bovis and adenomas was investigated. Two of 18 current adenoma patients (11%) were found to have S. bovis in their stool compared with 12 of 84 controls (14%). Six of 38 patients who had ever had a diagnosis of adenoma (16%) had S. bovis compared with 8 of 64 controls (13%). These results rule out a strong association between fecal carriage of S. bovis and adenomas; however, because of the relatively small sample size, a weak to moderate association cannot be excluded.