BackgroundThe aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy.MethodsWe collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone.ResultsImplant loss was dependent on the position and location of the implants (P = 0.05–0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determining survival. We observed significantly better outcomes when the implant was not loaded until at least 6 months after placement.ConclusionsAlthough the retrospective design of this study could be affected by selection and information biases, we conclude that a delayed loading protocol will give the best chance of implant osseointegration, stability and, ultimately, effective dental rehabilitation.

PTTM-enhanced dental implants were clinically effective in the prosthetic rehabilitation of postoncological patients. Larger long-term follow-up studies will help to evaluate clinical efficacy of PTTM dental implants.

Le Fort I osteotomy with impaction and advancement genioplasty are effective procedures for occlusal and aesthetic correction of juvenile idiopathic/rheumatoid patients. Mandibular procedures may evoke further condylar resorption with pain and functional impairment of the TMJ.

The head and neck are the sixth most common sites of cancer in the world; the survival rate at 5 years from diagnosis is 60%. Surviving patients, after the critical phase of the disease, require proper rehabilitation. The treatment of oral neoplasia, such as surgery and radiotherapy, may often determine significant disability, such as impaired speech, swallowing, mastication and facial deformity, with severe consequences on the quality of life of these patients. Dental implant-based prosthodontic rehabilitation is a consolidated technique for improving the quality of life in patients who have overcome oral cancer. Implants provide stability and support for removable prostheses in oral cavities seriously deformed by surgical treatment. Moreover, mobile prostheses have the advantage of being removable, to check the health of oral tissues and intercept possible relapses of the neoplasia. On the other hand, a lack of residual bone following resection makes it difficult to place implants in an ideal position, and patients who have been submitted to radiotherapy of the head and neck are reported to have a reduced success rate. This paper presents the case of a 67-year-old woman rehabilitated with dental implant-based prosthesis after a hemimandibulectomy due to osteoradionecrosis, without bone reconstruction.

In 2005 the WHO introduced the former odontogenic keratocyst to the category of benign odontogenic tumours. The change in terminology was based on the observation that the odontogenic keratocyst behaves as a neoplasm and not like a benign cystic lesion. The present paper is a retrospective analysis on the management of keratocystic odontogenic tumor over a period of 11 years (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) in the Department of Maxillo-Facial Surgery at the University of Rome "Sapienza", with particular focus on the surgical choices and the relative rates of relapse. The patient population consisted of 34 females and 43 males. Administered treatment modalities consisted of enucleation in 55 cases and radical resection in 22 cases. Nineteen percent of patients who underwent enucleation suffered KCOT relapse. No relapse was observed in the radical resection group with follow-up of 3-7 years. The goals of the treatment include elimination of the pathology and decrease of potential recurrence while minimizing harm to the patient. In the Authors' experience, conservative treatment still encompasses a high rate of recurrence; otherwise, resection provides the lowest recurrence rate, yet causes the most suffering to the patient. The issue surgeons encounter is whether to choose a conservative approach, reducing the morbidity to the patient, knowing that several operations may be required to eliminate recurrence; or being more aggressive and potentially more destructive, at the same time ensuring the best condition to avoid recurrence. Other studies are needed in order to find definitive guidelines for this challenging pathology.The WHO, in 2005, considered Odontogenic Keratocyst (OKC) to be a tumor and changed the term in Keratocystic Odontogenic Tumor (KCOT) like a unique lesion because of its locally aggressive behavior, high recurrence rate, and characteristic histologic appearance (I). Management of KCOT remains controversial owing to multiple different treatment protocols with different rates of recurrence. Several treatment modalities have been used in the management of KCOT: decompression, marsupialization, peripheral ostectomy with application of Camoy's solution, or liquid nitrogen cryotherapy; with most options supplementing the enucleation technique (2). Resection generally has been reserved for patients who had undergone several surgical procedures to remove the same recurring KCOT. The present paper is a retrospective analysis on the management of KCOT over a period of 11 years (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) in the Department of MaxilloFacial Surgery at the University ofRome "Sapienza", with particular focus on the surgical choices and the relative rates of relapse.