The paper sets out a new strategy for theory reduction by means of functional sub-types. This strategy is intended to get around the multiple realization objection. We use Kim's argument for token identity (ontological reductionism) based on the causal exclusion problem as starting point. We then extend ontological reductionism to epistemological reductionism (theory reduction). We show how one can distinguish within any functional type between functional sub-types. Each of these sub-types is coextensive with one type of realizer. By this means, a conservative theory reduction is in principle possible despite multiple realization. We link this account with Nagelian reduction, as well as Kim's functional reduction.
Objectives
This study aimed to evaluate the influence of vestibuloplasty on the clinical success and survival of dental implants in head and neck tumor patients.
Materials and methods
A retrospective single-center study was conducted. All patients received surgical therapy of a tumor in the head or neck and underwent surgical therapy and, if necessary, radiotherapy/radiochemotherapy. Patients with compromised soft tissue conditions received vestibuloplasty using a split thickness skin graft and an implant-retained splint. Implant survival and success and the influence of vestibuloplasty, gender, radiotherapy, and localizations were evaluated.
Results
A total of 247 dental implants in 49 patients (18 women and 31 men; mean age of 63.6 years) were evaluated. During the observation period, 6 implants were lost. The cumulative survival rate was 99.1% after 1 year and 3 years and 93.1% after 5 years for patients without vestibuloplasty, compared to a survival and success rate of 100% after 5 years in patients with vestibuloplasty. Additionally, patients with vestibuloplasty showed significantly lower peri-implant bone resorption rates after 5 years (mesial: p = 0.003; distal: p = 0.001).
Conclusion
This study demonstrates a high cumulative survival and success rate of dental implants after 5 years in head and neck tumor patients, irrespective of irradiation. Patients with vestibuloplasty showed a significantly higher rate of implant survival and significantly lower peri-implant bone resorption after 5 years.
Clinical relevance
Vestibuloplasty should always be considered and applied if required by the anatomical situations to achieve high implant survival/success rates in head and neck tumor patients.
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