De Ceulaer Joke, Magremanne Michèle, van Veen Andy, Scheerlinck Jan
Department of Oral and Maxillofacial Surgery, Sint-Elisabeth Ziekenhuis, Tilburg, The Netherlands.
J Oral Maxillofac Surg. 2010 Oct;68(10):2507-12. doi: 10.1016/j.joms.2010.01.023. Epub 2010 Jul 31.
The role of dental implants as part of functional and esthetic oral rehabilitation after ablative intraoral tumor surgery has been established. The purpose of this article is to highlight the phenomenon of tumor recurrence around dental implants.
Twenty-one consecutive cases of patients all treated surgically for squamous cell carcinoma of the oral mucosa between January 2003 and December 2007 were reviewed, regardless of staging. Dental rehabilitation was established by means of oral implants. Fifty-six implants were placed either during tumor ablation surgery (16 patients) of afterward (5 patients). Radiotherapy was given according to the guidelines of the NWHNT (Netherlands Working group on Head and Neck Tumors).
In the group of simultaneous implantation, 3 patients developed local recurrence around one of the implants. No recurrence was found in the group implanted in second stage surgery. Local recurrence around a dental implant is a severe oncological setback that drew our attention.
Influence on radiation fields and errors in surgical techniques are discussed, as well as the possibility of inducing changes in sensitized mucosa. Because of the small number of patients, no conclusions can be drawn. Further multicentered examinations should be performed.
牙种植体作为口腔内肿瘤切除术后功能和美学口腔修复一部分的作用已得到确立。本文的目的是强调牙种植体周围肿瘤复发的现象。
回顾了2003年1月至2007年12月期间连续接受手术治疗的21例口腔黏膜鳞状细胞癌患者,无论分期如何。通过口腔种植体进行牙齿修复。56颗种植体在肿瘤切除手术期间(16例患者)或之后(5例患者)植入。根据荷兰头颈肿瘤工作组(NWHNT)的指南进行放疗。
在同期种植组中,3例患者在其中一枚种植体周围出现局部复发。二期手术种植组未发现复发。牙种植体周围的局部复发是一个严重的肿瘤学挫折,引起了我们的关注。
讨论了对放射野的影响和手术技术中的失误,以及诱导致敏黏膜发生变化的可能性。由于患者数量较少,无法得出结论。应进行进一步的多中心检查。