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Head and Neck Cancer Treatment: DI Survival & Mucosal Overgrowth

February, 02, 2024 | Head & Neck Cancer

KEY TAKEAWAYS

  • The study aimed to compare the impact of surgery alone vs. surgery with RT/CRT on DI survival and the prevalence of mucosal overgrowth.
  • Researchers observed that radiation therapy did not significantly impact implant survival, with grafted bone exhibiting inferior survival compared to native bone.

The primary objective was to assess dental implant (DI) survival in head and neck cancer patients, a critical concern, that prompted a comparative study on surgery alone versus surgery with radiotherapy (RT) or chemoradiotherapy (CRT). Viivi Mattila and her team’s secondary objective was to evaluate the prevalence of mucosal overgrowth around DIs, post-treatment with or without mucosal grafts.

They conducted an observational retrospective study involving 59 patients diagnosed with malignant head and neck tumors who underwent DI placement between 2015 and 2019. An inclusive analysis was performed, gathering data on treatment modalities, oral rehabilitation with DI, prevalence of mucosal overgrowth, and precursor lesions from hospital records. Radiation doses were determined utilizing the sum of three-dimensional dose distributions.

The overall DI survival rate was 88%, with a comparable survival rate of 89% in irradiated jaws and 88% in nonirradiated jaws during the observational period (P = 0.415, mean follow-up was 2 years 10 months, range 9-82 months). Mucosal overgrowth occurred in 42 out of 196 implants (21%), of which 36 cases (86%) were associated with grafted areas (P < 0.001). Additionally, among all 59 oral cancer patients, 24% were diagnosed with oral lichen planus/lichenoid reaction.

The study concluded that radiation therapy did not significantly impact implant survival during the observational period. However, in grafted bone, implant survival was notably inferior compared to native bone. Furthermore, mucosal overgrowth around implants was more prevalent in mucosal-grafted areas compared to non-grafted regions.

The study is sponsored by the University of Helsinki and Helsinki and Uusimaa Hospital

Source: https://pubmed.ncbi.nlm.nih.gov/38273180/

Mattila V, Wilkman T, Avellán NL, et al (2024). “Survival of dental implants and occurrence of mucosal overgrowth in patients with head and neck cancer treated with/without radiotherapy and mucosal graft-two-year follow-up.” Clin Oral Investig. 2024 Jan 25;28(1):117. doi: 10.1007/s00784-023-05479-0. PMID: 38273180; PMCID: PMC10811186.

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