Objective To assess clinical and patient‐reported outcomes of implant‐prosthetic rehabilitations in patients with a history of head–neck cancer (HNC), treated with tumor resection without (TR) or with adjuvant radiotherapy (TR/RT). A healthy cohort rehabilitated with the same reconstructive protocols served as control group (C). Materials and Methods A total of 28 women and 29 men were considered in the present retrospective study. Participants received 322 implants, finally supporting 79 prosthetic reconstructions. Primary outcome was the assessment of implant and prosthetic survival rates. Furthermore peri‐implant soft tissue parameters (attached peri‐implant mucosa, AM; modified bleeding and plaque indices, mBI/mPI; probing depth, PD) and prosthetic technical complications were documented. Patient‐reported outcome measures (PROMs) by means of visual analog scales (VAS) and the Oral Health Impact Profile German 14 form (OHIP G14) were collected. For statistical purposes Chi‐square and Mann–Whitney‐U‐Test were adapted. Results After a mean follow‐up of 81.2 ± 50.3 months, implant survival rate was 98.1% (HNC‐TR), 98.2% (HNC‐TR/RT) and 100.0% (C), respectively (four implants failed in the HNC groups). HNC‐TR/RT showed significant higher mPI and mBI compared to C. Within HNC‐TR/RT, vestibuloplasty significantly reduced mBI and PD values. No failures occurred at the prosthetic level. Overall, higher VAS scores were reported for bar‐ compared with Locator‐retained prostheses. Furthermore, increased OHIP G14 values resulted for HNC‐TR/RT. Conclusions High survival rates on implant and prosthetic level were observed. The use of soft tissue grafts resulted in stabilization of the peri‐implant mucosa in irradiated patients. In terms of retention and chewing ability, participants preferred bars over Locator attachments.
Background : Management of head and neck cancer (HNC) requires surgical intervention and/or radio(chemo)-therapy. Subsequently, implantprosthetic treatment allows for a functional and esthetically pleasing rehabilitation. Clinical and patient-reported outcome measures (PROMs) are used to assess the reliability of such a reconstructive intervention. To date, data comparing implant-prosthetic rehabilitations in patients with and without a history of head and neck cancer are scarce. Aim/Hypothesis : To evaluate the clinical outcome of implant-prosthetic rehabilitations in HNC-patients after tumor resection (TR), partly along with radiotherapy (RT), and to assess the PROMs. Null hypothesis assumed no significant differences between HNC-TR/RT and a healthy population serving as control group (C). Materials and Methods : In the present retrospective investigation, a total of 57 patients (mean age 68.3 ± 10.3 y) received 72 prosthetic rehabilitations supported by 322 implants. Follow-up periods ranged between 12 and 262 months after implant placement. The HNC cohort included 38 participants (19 TR, 19 TR/RT). Split-skin grafts were used for vestibuloplasty in 28 HNC and 6 C patients. Survival rates of the implants as well as of the fixed and removable prostheses were evaluated, and technical complications assessed according to modified United States Public Health Service (USPHS) criteria. Further parameters like modified bleeding (mBI) and plaque (mPI) indices, probing depth (PD) and keratinized gingiva (KG) were collected. Visual analog scales (VAS) were used to include PROMs. In addition, oral health-related quality of life was evaluated with the Oral Health Impact Profile German 14 form (OHIP G14). Statistical analysis was performed using SPSS software. Results : The mean observation period resulted in 81.2 ± 50.3 months. Four implants were lost, thereof 2 implants in irradiated patients (both smokers). Implant survival rates ranged from 98.4% (HNC-TR/RT) to 99.0% (H). No significant differences in terms of mPI, mBI and PD between HNC-TR and HNC-TR/RT patients were found. Irradiated patients showed significantly lower mBI values after vestibuloplasty. At the prosthetic level, a survival rate of 100% was calculated. Chipping was calculated to be the most frequent technical complication (n = 4, 5.1%). Irrespective of the cohort, significantly higher VAS values in terms of prosthesis retention and lower OHIP G14 scores were found for overdentures retained by bars compared to locator attachments. Significantly increased OHIP G14 scores were reported by irradiated compared to NO-irradiated patients. Conclusions and Clinical Implications : High implant and prosthetic survival rates were observed for HNC-TR/RT patients, comparable to those of a healthy comfort treated under comparable conditions. Soft tissue augmentation and stabilization using split-skin grafts are liable in decreasing peri-implant inflammation. Bar-attachments should be preferred for a long-term reliable retention of removable prostheses.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.