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Illand C, Destruhaut F, Porporatti AL, Wulfman C, Naveau A, Rignon-Bret C. Implant Survival Rate in Mandible Reconstructed with Free Fibula Flaps After Oral Tumors: A Systematic Review and Meta-Analysis. Int J Oral Maxillofac Implants 2023; 38:976-985. [PMID: 37847839 DOI: 10.11607/jomi.10373] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
PURPOSE To assess the implant survival rate in mandibles reconstructed with free fibula flap after oral tumor resection after 1 year of prosthetic loading. A secondary objective was to compare immediate or delayed implant placement protocols in this population. MATERIALS AND METHODS Electronic and manual searches were performed on different databases for controlled and prospective trials that indicated implant survival rate. This systematic review followed PRISMA guidelines. Risk of bias was evaluated using Cochrane Collaboration tools. Meta-analyses heterogeneity source assessment and GRADE evaluation were performed among studies with identical follow-ups. RESULTS Among 305 primarily selected articles, 109 were eligible after reading the title and abstract, and 8 were included after full-text reading: 2 randomized controlled trials and 6 prospective studies comprising 140 patients and 507 implants. Meta-analyses estimated an overall survival rate of 97% (95% CI: 94% to 99%) after 1 year of prosthetic loading. The survival rate was 98% (95% CI: 94% to 100%) with immediate implantation and 97% (95% CI: 90% to 99%) with delayed implantation. Only 3 studies reported radiotherapy treatment, with no real impact on implant survival rate. Overall, 69% of tumors were benign. CONCLUSIONS Implant placement in vascularized fibula flaps in the mandible is recommended for patients undergoing segmental mandibular reconstruction after tumor resection. Within the limitations of this study, no significant difference in survival rates was found between immediate and delayed implant placement.
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Carrière M, Prudentos JB, Lecigne A, Laran A, Nguyen CT, Destruhaut F, Naveau A. Digital optimization of teeth set-up in an edentulous patient with partial glossectomy: a case report. J Prosthodont 2023. [PMID: 36966462 DOI: 10.1111/jopr.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/18/2023] [Accepted: 03/23/2023] [Indexed: 03/27/2023] Open
Abstract
The purpose of this clinical report was to describe the use of a piezographic impression associated with computer-aided design and computer-aided manufacturing (CAD-CAM) for teeth set-up and of digital tools for neuro-musculo-kinetic analyses. An edentulous patient with hemiglossectomy and heavily resorbed mandible consulted for complete denture rehabilitation to improve their masticatory function and speech. Master casts, wax rims and piezographic impression were scanned for digital prosthetic work. Two digital try-ins were performed to respect the neutral zone: try-in 1 with posterior crossbite and try-in 2 without crossbite. Muscle activity and mandibular kinetics were performed for each try-ins following the MAC2 protocol (six criteria): muscular tone, contraction synchrony, contraction efficiency, interocclusal rest distance, amplitude of mandibular movement and velocity. Try-in 2 showed better data than try-in 1 in all criteria: muscle tone (respectively 71% vs 59%), contraction synchrony (79% vs 75%), contraction efficiency (85% vs 77%), an increase in range of motion of 3.3 mm and a better velocity (0.35 sec ± 0.12 sec vs 0.57 sec ± 0.14 sec, p = 0.008). The piezographic impression, in combination with CAD-CAM, allowed the comparison of two prosthetic designs and the selection of the try-in with best neuro-musculo-kinetic results. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mathieu Carrière
- Faculty of Dental Medicine, Bordeaux University, Bordeaux University Hospital, Saint-André Hospital, Bordeaux, France
| | | | | | - Adrien Laran
- Faculty of Dental Medicine, Bordeaux University, Bordeaux University Hospital, Saint-André Hospital, Bordeaux, France
| | - Caroline T Nguyen
- Director of Examinations, National Dental Examining Board of Canada, Ottawa, Canada
| | - Florent Destruhaut
- Professor, Prosthodontics Unit, URU EvolSan, Toulouse III - Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - Adrien Naveau
- Associate Professor, Prosthodontics Department, Faculty of Dental Medicine, Bordeaux University, Bordeaux University Hospital, Saint-André Hospital, Bordeaux, France
- Academic Guest, Clinic of General, Special care and Geriatric Dentistry, University of Zürich, Zürich, Switzerland
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Naveau A, Kret M, Plaire V, Delorme O, Marchi S, de Bataille C, Destruhaut F, Arrive E, Bou C. Efficacy of a new membrane obturator prosthesis in terms of speech, swallowing, and the quality of life of patients with acquired soft palate defects: study protocol of the VELOMEMBRANE randomized crossover trial. Trials 2022; 23:221. [PMID: 35303932 PMCID: PMC8931575 DOI: 10.1186/s13063-022-06163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Soft palate defects created during oral cancer surgery may prevent complete palatal closure and trigger palatopharyngeal insufficiency. One current treatment employs a rigid obturator prosthesis; an extension of acrylic resin at the level of the hard palate ensures surface contact with the remaining musculature. Unfortunately, airflow escape often causes hypernasality, compromises speech intelligibility, and creates swallowing problems (including leakage of food and fluid into the nasal airway). We plan to test a new removable denture featuring a thick dental dam that serves as a membrane obturator. The principal objective of the clinical trial is a comparison of speech handicap levels after 1 month in patients with acquired velar insufficiencies who wear either the new device or a conventional, rigid obturator. The secondary objectives are between-device comparisons of the swallowing handicaps and the health-related qualities of life. Methods The VELOMEMBRANE trial is a superiority, open-labeled, two-way, random crossover clinical trial. Adult patients exhibiting velar or palatovelar substance loss after tumor excision and who are indicated for rigid obturator-mediated prosthetic rehabilitation will be recruited in two teaching hospitals in France. Fourteen participants will be randomly allocated to wear both prostheses for 1-month periods in either order. The new membrane obturator is a removable resin prosthesis incorporating a rigid extension that holds a dental dam to restore the soft palate. The primary outcome will be the extent of phonation-related disability (the overall score on the Voice Handicap Index [VHI]). The secondary outcomes will be the Deglutition Handicap Index and health-related quality of life scores of the European Organization for Research and Treatment of Cancer (EORTC). Discussion High-quality evidence will be provided to document the utility of a new medical device that may greatly improve the management and quality of life of patients with acquired velar insufficiency. Trial registration ClinicalTrials.govNCT04009811. Registered on 4 July 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06163-6.
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Affiliation(s)
- Adrien Naveau
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France. .,Université de Bordeaux, UFR des Sciences Odontologiques, 33076, Bordeaux, France. .,INSERM, Bio-ingénierie Tissulaire BioTisU1026, 33076, Bordeaux Cedex, France.
| | - Marion Kret
- CHU de Bordeaux, USMR, Pôle Santé publique, 33076, Bordeaux, France
| | - Valérie Plaire
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France
| | | | | | - Caroline de Bataille
- Université de Toulouse, Faculté de Chirurgie Dentaire, 31062, Toulouse, France.,CHU de Toulouse, Hôpital de Rangueil, 31059, Toulouse Cedex, France
| | - Florent Destruhaut
- Université de Toulouse, Faculté de Chirurgie Dentaire, 31062, Toulouse, France.,CHU de Toulouse, Hôpital de Rangueil, 31059, Toulouse Cedex, France.,Evolution and Oral Health Laboratory (EvolSan), Paul Sabatier University, Toulouse, France
| | - Elise Arrive
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France.,Université de Bordeaux, UFR des Sciences Odontologiques, 33076, Bordeaux, France
| | - Christophe Bou
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France.,Université de Bordeaux, UFR des Sciences Odontologiques, 33076, Bordeaux, France
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Delrieu J, Joniot S, Vergé T, Destruhaut F, Nasr K, Canceill T. The use of PEEK as an occlusal splint in a patient with histaminosis: A case report. Spec Care Dentist 2022; 42:646-650. [PMID: 35522194 PMCID: PMC9790372 DOI: 10.1111/scd.12725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/14/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
Poly-(etheretherketone) (PEEK) began to be used in the field of odontology more than 10 years ago, especially in relation to the creation of removable partial dentures. Here we report the case of a 62 years old woman diagnosed with histamine intolerance (or histaminosis), who presented a very particular set of oral symptoms. She described a certain tingling, burning, and swelling of the mucous membranes. These symptoms seem to be linked with the wearing of a resin occlusal splint which was initially prescribed to compensate for the absence of a meniscus in the left temporomandibular joint of the patient. After a multidisciplinary concertation, it was decided to create a new splint with a resin-free material. For this reason, the production of a PEEK prosthesis was considered. Following the installation of the occlusal splint in the patient, and after clinical adjustments, she described the occlusion positioning as correct and a disappearance of the symptomatology. Mechanically, PEEK seems to have higher mechanical resistance than PMMA. Despite these characteristics, the use of PEEK still presents some limitations, especially concerning the overall aesthetic. Additionally, the prescription of the occlusal splint seems to be limited to patients who need special care. The case presented here thus confirms a new perspective concerning the use of PEEK as an occlusal splint.
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Affiliation(s)
- Julien Delrieu
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de ToulouseToulouseFrance,Université Toulouse 2 Jean‐Jaurès, UMR Education, FormationTravail, SavoirsToulouseFrance
| | - Sabine Joniot
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de ToulouseToulouseFrance
| | - Thierry Vergé
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de ToulouseToulouseFrance
| | - Florent Destruhaut
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de ToulouseToulouseFrance,URU EvolSan, Université Toulouse III Paul SabatierToulouseFrance
| | - Karim Nasr
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de ToulouseToulouseFrance
| | - Thibault Canceill
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de ToulouseToulouseFrance,CIRIMAT, Université Toulouse III Paul Sabatier, CNRS, INPT, Faculté de PharmacieToulouseFrance
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Esclassan R, Rumerio A, Monsarrat P, Combadazou JC, Champion J, Destruhaut F, Ghrenassia C. Optimal duration of ultra low frequency-transcutaneous electrical nerve stimulation (ULF-TENS) therapy for muscular relaxation in neuromuscular occlusion: A preliminary clinical study. Cranio 2016; 35:175-179. [DOI: 10.1080/08869634.2016.1171479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | - Paul Monsarrat
- Dental Faculty of Toulouse France , France
- Private Practice in Toulouse , France
| | | | - Jean Champion
- Dental Faculty of Toulouse France , France
- Private Practice in Toulouse , France
| | - Florent Destruhaut
- Dental Faculty of Toulouse France , France
- Private Practice in Toulouse , France
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Destruhaut F, Pomar P, Esclassan R, Rignon-Bret C. Decision making for residual palatoalveolar cleft defects: a new classification. INT J PROSTHODONT 2015; 28:167-8. [PMID: 25822303 DOI: 10.11607/ijp.4123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Oral rehabilitation of adult patients with cleft lip and palate is related to the severity of the anatomical and functional alterations that hamper the proper closure of the nasopharynx. The ideal treatment is closure by bone graft and orthodontics. However, when surgery is not possible or when the patient does not wish to undergo surgery, a palatal prosthesis may offer the best solution in most clinical situations. The authors of this article propose a new classification to help the practitioner with decision making and prosthetic treatment planning for residual palatoalveolar cleft defects.
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