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口腔癌患者肿瘤切除术同期植入种植体的优势:一项前瞻性 5 年临床试验。

Benefits of dental implants installed during ablative tumour surgery in oral cancer patients: a prospective 5-year clinical trial.

机构信息

Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

出版信息

Clin Oral Implants Res. 2010 Sep;21(9):971-9. doi: 10.1111/j.1600-0501.2010.01930.x.

Abstract

OBJECTIVE

This prospective study assessed treatment outcome and patient satisfaction of oral cancer patients with a mandibular overdenture on implants up to 5 years after treatment.

MATERIALS AND METHODS

At baseline, 50 consecutive edentulous oral cancer patients, in whom prosthetic problems were expected after oncological treatment, were evaluated by standardized questionnaires and clinical assessments. All implants were installed during ablative tumour surgery in native bone in the interforaminal area. About two-thirds of the patients (n=31) had radiotherapy post-surgery (dose >40 Gy in the interforaminal area).

RESULTS

At the 5-year evaluation, 26 patients had passed away and four patients had to be excluded from the analyses, because superstructures were not present, due to persistent local irritation (n=2), loss of three implants (n=1) and the impossibility of making an overdenture related to tumour and oncological surgery-driven anatomical limitations (n=1). In the remaining 20 patients, the prosthesis was still in function (76 implants). During the 5-year follow-up, total 14 implants were lost, 13 in irradiated bone (survival rate 89.4%, dose >40 Gy) and one in non-irradiated bone (survival rate 98.6%). Peri-implant tissues had a healthy appearance and remained healthy over time. Patients were satisfied with their dentures.

CONCLUSIONS

It was concluded that oral cancer patients can benefit from implants installed during ablative surgery, with a high survival rate of the implants, a high percentage of rehabilitated patients and a high denture satisfaction up to 5 years after treatment.

摘要

目的

本前瞻性研究评估了在接受肿瘤治疗后,使用下颌覆盖义齿种植体的口腔癌患者的治疗效果和患者满意度,随访时间长达 5 年。

材料与方法

在基线时,对 50 名连续的无牙口腔癌患者进行评估,这些患者在接受肿瘤治疗后预计会出现修复体问题。通过标准化问卷和临床评估进行评估。所有种植体均在肿瘤切除术期间安装在原生骨的颌间区域。大约三分之二的患者(n=31)在手术后接受了放疗(在颌间区域的剂量>40 Gy)。

结果

在 5 年评估时,26 名患者已经去世,4 名患者因以下原因被排除在分析之外:由于持续的局部刺激,导致修复体缺失(n=2);3 个种植体丢失(n=1);由于肿瘤和肿瘤手术驱动的解剖学限制,无法制作覆盖义齿(n=1)。在剩余的 20 名患者中,义齿仍在使用中(76 个种植体)。在 5 年的随访中,总共丢失了 14 个种植体,其中 13 个在接受放疗的骨中(存活率 89.4%,剂量>40 Gy),1 个在未接受放疗的骨中(存活率 98.6%)。种植体周围组织外观健康,且随着时间的推移保持健康。患者对他们的义齿感到满意。

结论

本研究表明,在接受肿瘤切除术期间安装种植体的口腔癌患者可以从中受益,种植体的存活率高,接受康复治疗的患者比例高,且在治疗后 5 年内对义齿的满意度高。

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