Sarah A Hessling1, Falk Wehrhan2, Christian M Schmitt3, Manuel Weber4, Tilo Schlittenbauer3, Martin Scheer5. 1. Intern, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. Electronic address: Sarah.hessling@uk-erlangen.de. 2. Assistant Medical Director, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. 3. Medical Specialist, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. 4. Intern, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. 5. Head, Department for Oral and Craniomaxillofacial and Facial Plastic Surgery, Johannes Wesling Clinic Minden, Minden, Germany.
Abstract
PURPOSE: Radiotherapy and compromised vital bone and/or surrounding soft tissue can be a challenge to the successful osseointegration of dental implants. We evaluated the long-term results of dental implants in patients with oral cancer. MATERIALS AND METHODS: To address the research purpose, we designed and implemented a retrospective cohort study that included patients with oral cancer who had received dental implants from 2003 to 2011. The data were collected from a clinical oncology database. The predictor variables included a set of heterogeneous variables grouped into logical sets of demographics, surgical treatment, dental rehabilitation, radiotherapy type, and tumor entity. The primary outcome variable was implant survival; the secondary outcome variable was peri-implantitis. The descriptive statistics, survival time analysis, Kaplan-Meier implant survival curves, and Cox hazard proportional modeling were computed. RESULTS: The study sample included 59 patients with oral cancer (20 women [33.9%], 39 men [66.1%]; mean age at tumor diagnosis, 55 years), who had had 272 implants placed during the study period. The mean follow-up period was 30.9 months (range 3 to 82). Of the 272 implants, 269 (98.9%) and 264 (97.1%) had survived for 2 and 5 years, respectively. During the observation period, 10 implants were lost (3.7%). Of the implant failures, 82% occurred in transplanted bone (4 fibula flaps, 4 iliac crests, and 2 native mandibles). We observed peri-implantitis caused by insufficiently attached gingiva and bone loss in 182 of the implants (67%). The factors associated with implant failure were peri-implantitis, insufficient soft and hard tissue, muscle dysfunction, and xerostomia. CONCLUSIONS: Implant-based rehabilitation in oncology patients can achieve a high long-term success rate, although risk factors such as impaired muscle function and a high frequency of peri-implantitis can affect healing.
PURPOSE: Radiotherapy and compromised vital bone and/or surrounding soft tissue can be a challenge to the successful osseointegration of dental implants. We evaluated the long-term results of dental implants in patients with oral cancer. MATERIALS AND METHODS: To address the research purpose, we designed and implemented a retrospective cohort study that included patients with oral cancer who had received dental implants from 2003 to 2011. The data were collected from a clinical oncology database. The predictor variables included a set of heterogeneous variables grouped into logical sets of demographics, surgical treatment, dental rehabilitation, radiotherapy type, and tumor entity. The primary outcome variable was implant survival; the secondary outcome variable was peri-implantitis. The descriptive statistics, survival time analysis, Kaplan-Meier implant survival curves, and Cox hazard proportional modeling were computed. RESULTS: The study sample included 59 patients with oral cancer (20 women [33.9%], 39 men [66.1%]; mean age at tumor diagnosis, 55 years), who had had 272 implants placed during the study period. The mean follow-up period was 30.9 months (range 3 to 82). Of the 272 implants, 269 (98.9%) and 264 (97.1%) had survived for 2 and 5 years, respectively. During the observation period, 10 implants were lost (3.7%). Of the implant failures, 82% occurred in transplanted bone (4 fibula flaps, 4 iliac crests, and 2 native mandibles). We observed peri-implantitis caused by insufficiently attached gingiva and bone loss in 182 of the implants (67%). The factors associated with implant failure were peri-implantitis, insufficient soft and hard tissue, muscle dysfunction, and xerostomia. CONCLUSIONS: Implant-based rehabilitation in oncology patients can achieve a high long-term success rate, although risk factors such as impaired muscle function and a high frequency of peri-implantitis can affect healing.
Authors: Amit Walia; Joshua Mendoza; Craig A Bollig; Ethan J Craig; Ryan S Jackson; Jason T Rich; Sidharth V Puram; Sean T Massa; Patrik Pipkorn Journal: Laryngoscope Date: 2021-02-11 Impact factor: 2.970