Dental Implant Failure Risk in Post Oncological Patients, a Retrospective Study and Sapienza Head and Neck Unit Decisional Protocol- 7 Years of Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Chemotherapy/Other Medical Therapy
2.1.1. Cytotoxic Drugs for Chemotherapy
2.1.2. Antiresorptive (AR) Drugs
Bisphosphonates
Denosumab
2.1.3. Other ONJ-Related Drugs (Not Prescribed for Head and Neck Cancer)
- Drugs with a prevalent anti-angiogenic action (bevacizumab e aflibercept).
- Tyrosine kinase inhibitors (sunitinib, sorafenib, cabozantinib, regorafenib, axitinib)m-TOR inhibitors (temsirolimus, everolimus).
2.2. Radiotherapy
2.3. Bone Tissue Condition
2.3.1. Systemic Factors
- Patient’s age:
- General health:
- Smoking:
2.3.2. Local Factors
- Bone quality, quantity, and anatomical location:
2.4. Soft Tissue Condition
2.4.1. Tongue Mobility
2.4.2. Keratinized Gengiva
Red Code
- Chemotherapy: intravenous antiresorptive drugs assumption for bone metastases.
- Radiotherapy: future prosthesis zone directly irradiated with a total dose ≥66 Gy (2 Gy/fraction).
- Bone tissue condition: insufficient bone volume, the impossibility of bone augmentation for implant insertion, presence of jaw plates.
Yellow Code
- Adjuvant Chemotherapy/antiresorptive (AR) or antiangiogenic (AA) therapy
- The medical therapy specifies (drug type, dosage, the way of administration, and period of intake).
- The specifics of any additional pharmacological therapy (cortisone, anticoagulative, anti-aggregating drugs).
- The presence of any pathology that may interfere with the healing processes of the bone.
- 2.
- Radiotherapy
- 3.
- Bone tissue condition
- A bone height of at least 8 mm.
- A bone thickness that allows keeping at least 1 mm of bone around the implant itself.
- A healthy and good quality tissue.
- 4.
- Soft Tissue Condition.
Green Code
- No chemotherapy.
- No radiotherapy or a dose <50 Gy received by the future implant zone. Attention should be paid to obtain an appropriate result even in case of dose <50 Gy.
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Informed Consent Statement
Conflicts of Interest
References
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Implant Failure Risk Factors | Risk Entity | |
---|---|---|
CHEMOTHERAPY or OTHER MEDICAL THERAPY | FOR BONE METASTASES | |
ADJUVANT CHEMOTHERAPY | ||
OSTEOMETABOLIC DRUG THERAPY | ||
NO CHEMOTHERAPY OR OTHER DRUG THERAPY | ||
RADIOTHERAPY (dose at the implant zone) | DOSE ≥ 66 Gy | |
50 Gy ≥ DOSE < 66 Gy | ||
DOSE < 50 Gy | ||
NO RADIOTHERAPY | ||
BONE TISSUE | NO BONE PRESENT/JAW PLATES PRESENT | |
PARTIALLY PRESENT OR UNFAVORABLE SISTEMIC/LOCAL CONDITIONS | ||
PRESENT | ||
RECONSTRUCTED BONE | ||
SOFT TISSUE | LOW TONGUE MOBILITY | |
DEFICIENCY/ABSENCE OF KERATINIZED GENGIVA IN FUTURE IMPLANT INSERTION ZONE | ||
SUFFICIENT KERATINIZED GENGIVA IN FUTURE IMPLANT INSERTION ZONE | ||
NORMAL TONGUE MOBILITY | ||
LEGEND | ||
HIGH RISK OF IMPLANT FAILURE | ||
MODERATE RISK OF IMPLANT FAILURE | ||
LOW RISK OF IMPLANT FAILURE |
Total Number of Patients Rehabilitated with Implants | Total Number of Insterted Implants | Total Number of Lost Implants | % of Lost Implants |
---|---|---|---|
42 | 200 | 9 | 4.5% |
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Brauner, E.; Valentini, V.; Romeo, U.; Cantore, M.; Laudoni, F.; Rajabtork Zadeh, O.; Formisano, V.; Cassoni, A.; Della Monaca, M.; Battisti, A.; et al. Dental Implant Failure Risk in Post Oncological Patients, a Retrospective Study and Sapienza Head and Neck Unit Decisional Protocol- 7 Years of Follow-Up. Diagnostics 2022, 12, 1863. https://doi.org/10.3390/diagnostics12081863
Brauner E, Valentini V, Romeo U, Cantore M, Laudoni F, Rajabtork Zadeh O, Formisano V, Cassoni A, Della Monaca M, Battisti A, et al. Dental Implant Failure Risk in Post Oncological Patients, a Retrospective Study and Sapienza Head and Neck Unit Decisional Protocol- 7 Years of Follow-Up. Diagnostics. 2022; 12(8):1863. https://doi.org/10.3390/diagnostics12081863
Chicago/Turabian StyleBrauner, Edoardo, Valentino Valentini, Umberto Romeo, Marco Cantore, Federico Laudoni, Oriana Rajabtork Zadeh, Valeria Formisano, Andrea Cassoni, Marco Della Monaca, Andrea Battisti, and et al. 2022. "Dental Implant Failure Risk in Post Oncological Patients, a Retrospective Study and Sapienza Head and Neck Unit Decisional Protocol- 7 Years of Follow-Up" Diagnostics 12, no. 8: 1863. https://doi.org/10.3390/diagnostics12081863