Osteointegration in Oncologic Patients: A Case Report.
Osteointegration in oncologic patients: a case report.
Filed under: Rehab Centers
Ann Stomatol (Roma). 2012 Apr; 3(2 Suppl): 37-40
Carini F, Bucalo C, Saggese V, Monai D, Porcaro G
the present case report aims at illustrating how implant-prosthetic rehabilitation in patients with oral cancer resection aids to improve their quality of life.a patient with verrucous squamous cell carcinoma of the mandible was treated with surgery and rehabilitation with three interforaminal dental implants and Toronto bridge. Three years after treatment, because of cancer recurrence, a segment of jaw and one of the three mandibular implants were removed. The histological examination showed healthy bone contact to implant surface, despite proximity to the neoplastic area.the case shows the maintainance of the osseointegration implants despite the cancer recurrence in the same area.endosseous implants represent a useful and valid tool for the prosthetic rehabilitation of cancer patients. Long-term effects of implant-prosthetic rehabilitation in patients with cancer still need to be verified. It would be interesting to confirm the data obtained by numerical studies of representative samples.
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Implant-supported denture rehabilitation on a hemimandibulectomized patient: a case report.
Filed under: Rehab Centers
Ann Stomatol (Roma). 2012 Apr; 3(2 Suppl): 26-31
Carini F, Gatti G, Saggese V, Monai D, Porcaro G
the treatment of oral cancer requires different surgical approaches such as marginal or segmental mandibular resection in order to allow a safe removal of the neoplastic lesion. The aim of this work is to evaluate the efficacy of an implant-supported denture rehabilitation for restoring oral function and facial appearance on a hemimandibulectomized patient.the patient was a 64 years old man, hard smoker and moderate drinker. Due to a jaw neoplastic lesion, he underwent a hemimandibulectomy, followed by the insertion of 4 implant fixtures at the chin cap symphysis site. The denture rehabilitation consisted in an over-denture mounted onto a bar furnished by a condylar eminence in articulation with the glenoid fossa of the upper denture.this type of implant-supported denture rehabilitation allows the recovery of the masticatory function and the mandibular reposition with a satisfactory restoration of the proper facial symmetry and appearance.in the edentulous patient implant-supported denture with artificial condyle allows the recovery of the masticatory function without the need of additional operations to re-establish the temporomandibular joint anatomy. It is currently considered as a low invasive technique with very low risk of side effects.
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Implant-supported rehabilitation of a patient with mandibular ameloblastoma.
Filed under: Rehab Centers
Ann Stomatol (Roma). 2012 Apr; 3(2 Suppl): 21-5
Carini F, Francesconi M, Saggese V, Monai D, Porcaro G
this report describes the masticatory implant- supported rehabilitation of a patient undergoing resection for mandibular ameloblastoma.in the reported case the patient underwent resection and reconstruction with a fibula flap for masticatory rehabilitation of 7 implants at the level of the mandible.ameloblastoma is a benign locally invasive tumor of maxillary bones that often causes facial disfigurement. The dental management of the patient requires a collaboration of various specialists such as anesthetists, maxillofacial surgeons, and dentists.in patients with oral cancers such as ameloblastoma, the correct planning of surgery for the tumor resection as well as prosthetic rehabilitation are crucial. Osseointegrated implants open a new perspective of treatment to improve the quality of life of patients resected for cancer.
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Implant rehabilitation in patients irradiated for head and neck cancer: role of Intensity-Moduled Radiotherapy (IMRT) in planning the insertion site.
Filed under: Rehab Centers
Ann Stomatol (Roma). 2012 Apr; 3(2 Suppl): 8-20
Carini F, Pisapia V, Monai D, Barbano L, Porcaro G
currently, head and neck irradiation is not considered an absolute contraindication for implant placement (1), especially due to the transition from conventional to conformal radiotherapy. However, there is a difference in the success rate of implant placement between irradiated and non-irradiated bones (5). Successful osseointegration is mainly affected by the total dose of radiation (6). The main purpose of this study was to minimize problems related to radiation dose by evaluating in advance the most suitable site for implant insertion on the basis of the mean absorbed dose. Additional aims were: to estimate the appropriate timing for implant insertion in irradiated bones, to analyze the difference in stability between maxilla and mandible, and to evaluate the success of implants with wrinkled microgeometry and increased layer of TiO(2).five patients who had been irradiated for head and neck cancer using intensity-modulated radiotherapy (IMRT) were recruited for our study. Surgical procedures were performed following a pre-surgical evaluation of the correct insertion position of implant fixtures. The latter was based on a scrutiny of dose-volume histograms (DVH) developed by a team of experts in medical physics and radiotherapists after dentists had contoured the volumes of interest. Student’s t test and Pearson’s correlation test were used for comparison and correlation between the variables considered.the percentage of osseointegration was 100%, which supports the usefulness of the adopted technique. A statistically significant difference in stability and crestal bone resorption emerged in the comparison between maxilla and mandible, but not between times of insertion. Moreover, there was a significant correlation between radiation dose and ISQ values: an increase in radiation dose corresponded to a decrease in primary stability. However, the correlation between ISQ values and implant length was not significant as well as that between primary stability and implant diameter.implantology guided by assessment of absorbed irradiation dose in the site to be rehabilitated can lead both to an increase in implant survival into irradiated tissue bone, and to a reduction in the incidence of ORN. However, both a larger sample size and the development of long-term prospective studies are necessary to validate the described method.
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