Sanne Werner Møller Andersen1, Camilla Ottesen2, Klaus Gotfredsen2, Simon Storgård Jensen3,4, Thomas Kofod3, Morten Schiodt3,5. 1. Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. sanne.werner.moeller.andersen@regionh.dk. 2. Department of Oral Rehabilitation, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 20, 2200, Copenhagen N, Denmark. 3. Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. 4. Department of Oral Surgery, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 20, 2200, Copenhagen N, Denmark. 5. Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200, Aarhus N, Denmark.
Abstract
PURPOSE: Implant placement in patients with cancer receiving high-dose antiresorptive medication (HDAR) is considered contraindicated. This prospective, feasibility study tested the hypothesis that dental implants can be placed in such patients by applying a staged implant placement protocol with submerged healing. METHODS: Three groups of patients on HDAR were included as follows: group 1: patients who underwent tooth extraction, without the development of medication-related osteonecrosis of the jaws (MRONJ); group 2: patients with surgically treated MRONJ who had demonstrated clinical healing for at least 3 months; group 3: patients with established MRONJ who was planned for surgical resection and simultaneous implant placement. RESULTS: A total of 49 implants were placed in 27 patients (group 1: 12, group 2: 7 and group 3: 8). HDAR included bisphosphonates and denosumab. The mean HDAR time was 25 months (SD: ± 18.4, range 3-68 months). An abutment operation was performed 4 months following the implant placement (SD: ± 1.9, range 3-14 months). All patients healed uneventfully. CONCLUSIONS: This study demonstrated that it is feasible to insert dental implants and perform an abutment surgery in patients with cancer on HDAR, without the development of MRONJ. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04741906.
PURPOSE: Implant placement in patients with cancer receiving high-dose antiresorptive medication (HDAR) is considered contraindicated. This prospective, feasibility study tested the hypothesis that dental implants can be placed in such patients by applying a staged implant placement protocol with submerged healing. METHODS: Three groups of patients on HDAR were included as follows: group 1: patients who underwent tooth extraction, without the development of medication-related osteonecrosis of the jaws (MRONJ); group 2: patients with surgically treated MRONJ who had demonstrated clinical healing for at least 3 months; group 3: patients with established MRONJ who was planned for surgical resection and simultaneous implant placement. RESULTS: A total of 49 implants were placed in 27 patients (group 1: 12, group 2: 7 and group 3: 8). HDAR included bisphosphonates and denosumab. The mean HDAR time was 25 months (SD: ± 18.4, range 3-68 months). An abutment operation was performed 4 months following the implant placement (SD: ± 1.9, range 3-14 months). All patients healed uneventfully. CONCLUSIONS: This study demonstrated that it is feasible to insert dental implants and perform an abutment surgery in patients with cancer on HDAR, without the development of MRONJ. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04741906.
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