María L Sandoval1, Evan B Rosen2, Allen J Robert3, Jonas A Nelson3, Evan Matros3, Daphna Y Gelblum4. 1. New York Medical College, Valhalla, New York. 2. Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. 3. Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. 4. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Abstract
OBJECTIVES: The current pilot study aims to report short-term experience as it relates to acute radiotherapy treatment outcomes comparing patients with immediate dental implants in fibula free flap reconstructions to a historical cohort of patients with fibula free flap reconstructions without dental implants. MATERIALS AND METHODS: A retrospective review of patients who underwent segmental mandibulectomy, reconstruction with fibula free flaps, and adjuvant radiotherapy with (n = 10) and without immediate dental implants (n = 10) at a tertiary cancer center from 2015 to 2018 was performed (IRB #17-271). Incidence of postoperative complications, time to initiation of radiation therapy, development of acute toxicity, and patient reported outcome data were recorded. The radiation plans were evaluated to identify the mean and maximum doses received by the mandible and oral cavity as well as the locations of radiation global hot spots. RESULTS: There was a similar number of postoperative complications in both cohorts, with three events in the case group and two events in the control group. Patients with dental implants reported less trismus than control patients. Evaluation of the radiation treatment plans revealed similar median radiation global hot spots in both groups. CONCLUSIONS: The current study suggests that the presence of dental implants does not increase the risk of complications following surgery or during radiation treatment. Implants do not alter radiation dosimetry but do appear to positively impact early patient quality of life. Although longer follow-up is needed, based on this preliminary experience, cancer patients should be offered this type of reconstruction without fear of impacting radiation timing or delivery.
OBJECTIVES: The current pilot study aims to report short-term experience as it relates to acute radiotherapy treatment outcomes comparing patients with immediate dental implants in fibula free flap reconstructions to a historical cohort of patients with fibula free flap reconstructions without dental implants. MATERIALS AND METHODS: A retrospective review of patients who underwent segmental mandibulectomy, reconstruction with fibula free flaps, and adjuvant radiotherapy with (n = 10) and without immediate dental implants (n = 10) at a tertiary cancer center from 2015 to 2018 was performed (IRB #17-271). Incidence of postoperative complications, time to initiation of radiation therapy, development of acute toxicity, and patient reported outcome data were recorded. The radiation plans were evaluated to identify the mean and maximum doses received by the mandible and oral cavity as well as the locations of radiation global hot spots. RESULTS: There was a similar number of postoperative complications in both cohorts, with three events in the case group and two events in the control group. Patients with dental implants reported less trismus than control patients. Evaluation of the radiation treatment plans revealed similar median radiation global hot spots in both groups. CONCLUSIONS: The current study suggests that the presence of dental implants does not increase the risk of complications following surgery or during radiation treatment. Implants do not alter radiation dosimetry but do appear to positively impact early patient quality of life. Although longer follow-up is needed, based on this preliminary experience, cancer patients should be offered this type of reconstruction without fear of impacting radiation timing or delivery.
Authors: Jamie P Levine; Jin Soo Bae; Marc Soares; Lawrence E Brecht; Pierre B Saadeh; Daniel J Ceradini; David L Hirsch Journal: Plast Reconstr Surg Date: 2013-06 Impact factor: 4.730
Authors: Robert J Allen; Deana S Shenaq; Evan B Rosen; Snehal G Patel; Ian Ganly; Jay O Boyle; Jonas A Nelson; Evan Matros Journal: Plast Reconstr Surg Glob Open Date: 2019-01-14
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Authors: Rachel A Anolik; Jonas A Nelson; Evan B Rosen; Joseph Disa; Evan Matros; Robert J Allen Journal: Plast Reconstr Surg Glob Open Date: 2021-09-17