Rehabilitation with dental implants of oral cancer patients

Dental Implants Installed in Irradiated Jaws

“…In this review, the lower mean values of implant success in irradiated subjects were probably due to the interaction between radiation dose and host response (Werkmeister et al, 1999;Gramstrom, 2003;Schoen et al, 2007). Schoen et al (2007) reported that radiation doses > 40 Gy may jeopardize the regenerative capacity of the osseous tissue.…”

“…The overall RR of the effect of radiotherapy on implant survival might have been overestimated. For example, the study by Granstrom et al (1999), which had a higher weight (50.6%) in the metaanalysis (Figure 3), reported a higher failure rate (53.7%) in the irradiated group than did the other studies: 6.1% (Albrektsson et al, 1988; Esser et al, 1999), 26.6% (Werkmeister et al, 1999), 20% (Katsoulis et al, 2006), 1.4% (Landes and Kovács, 2006), and 3.3% (Schepers et al, 2006). Consequently, the overall RR may not be representative despite the lack of significant heterogeneity (p = .21, I 2 = 28%).…”

“…Thirteen case series were considered eligible for inclusion (Albrektsson et al, 1988;Eckert et al, 1996;Niimi et al, 1997;Andersson et al, 1998;Brogniez et al, 1998;Esser et al, 1999;Granstrom et al, 1999;Werkmeister et al, 1999;Goto et al, 2002;Visch et al, 2002;Landes and Kovacs, 2006 Excluded publications, not fulfilling inclusion criteria (n = 7): Alsaadi et al, (2008) included only two subjects of an overall sample of 700 patients Schliephake et al, (1999) did not report number of implants lost Weischer et al, (1996), Keller et al, (1997), Ihara et al, (1998), Meriscke-Sterm et al, (1999) and Linsen et al, (2012) …”

“…The findings regarding the domains of the modified Newcastle-Ottawa scale were as follows: 1: none of the studies reported sample size calculations; 2 and 3: in all of the studies, the representativeness of the irradiated and nonirradiated (when described) patients was considered to be adequately addressed; 4: assessment of peri-implant conditions was considered adequate in 8 studies (Albrektsson et al, 1988;Andersson et al, 1998;Brogniez et al, 1998;Esser et al, 1999;Granstrom et al, 1999;Goto et al, 2002;Visch et al, 2002;Landes and Kovacs, 2006) and unclear for the remaining articles; 5: only Albrektsson et al (1988) and Granstrom et al (1999) did not describe whether radiotherapy was performed before or after implant placement; 6: none of the studies reported training or calibration of the examiners of clinical outcome; 7: 2 studies had a prospective design (Visch et al, 2002;Landes and Kovacs, 2006); 8: 2 studies reported that all patients received similar implant therapy (Esser et al, 1999;Schepers et al, 2006); 9: 1 publication described statistical assessment performed with control for confounders (Visch et al, 2002); 10: none of the authors described whether independent blind assessment of peri-implant conditions was used; An approximate number of implants was calculated based on the survival rate (%), as well only data from implants placed in residual bone were extracted from the study. Goto et al 11: all of the studies described the radiation doses used for oncologic treatment, except for Albrektsson et al (1988); 12: in 2 publications, > 70% of the treated patients were followed during the entire study period (Landes and Kovacs, 2006;Katsoulis et al, 2013); 13: Esser et al (1999), Granstrom et al (1999), Schepers et al (2006), Werkmeister et al (1999), Goto et al (2002) and Visch et al (2002) compared their outcomes using statistical analyses; and 14: all authors defined the number of patients and/or implants per group as the unit of analysis.…”

Intérêt de l’utilisation de l’oxygénothérapie hyperbare en prévention de l’échec implantaire chez le patient irradié

“…La mise en place précoce d'implants dans une zone qui pourrait être le siège d'une nouvelle exérèse chirurgicale ne semble pas une bonne indication. La prolongation du délai d'attente avant la mise en place des implants permet également d'éviter cette situation [88]. Toutefois, au-delà du délai de 6 mois, il n'existe aucun consensus sur la période la plus favorable pour la pose d'implants en terrain irradié [30].…”