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牙种植体周围的口腔鳞状细胞癌

Oral squamous cell carcinoma in the vicinity of dental implants.

作者信息

Moergel Maximilian, Karbach Julia, Kunkel Martin, Wagner Wilfried

机构信息

Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center Mainz, Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Rheinland-Pfalz, Germany,

出版信息

Clin Oral Investig. 2014 Jan;18(1):277-84. doi: 10.1007/s00784-013-0968-5. Epub 2013 Mar 16.

Abstract

OBJECTIVES

The study at hand presents a cohort of patients treated for carcinomas in the vicinity of dental implants for identification of potential risk factors.

MATERIALS AND METHODS

The retrospective analysis covers patients treated for peri-implant carcinoma at our department between 1995 and 2011. An additional literature search focused likewise on peri-implant carcinomas. Obtained articles were screened for relevant risk factors and discussed in relation to our patient cohort.

RESULTS

Fifteen patients were treated for peri-implant carcinoma. Six reported ongoing alcohol/tobacco consumption. Nine had a previously reported carcinoma of whom six had received radiotherapy after surgery. Time from implant placement until carcinoma diagnosis was 53.4 months on average. The literature search revealed 25 patients with peri-implant carcinoma and one with a sarcoma. Eight patients reported alcohol/tobacco consumption. Most patients exhibited risk factors for possible malignant transformation: previous carcinoma (n = 12), lichen (n = 4), irradiation (n = 3), and leukoplakia (n = 3). The average time until diagnosis was 51.6 months.

CONCLUSIONS

Smoking, alcohol consumption, and the history of previous carcinoma characterize patients at risk for a peri-implant carcinoma. A balanced gender ratio might point at a higher risk for woman and additional risk factors promoting carcinogenesis apart from tobacco and alcohol consumption, a novel finding that has to be proven by larger patient counts.

CLINICAL RELEVANCE

The incidence of carcinomas next to dental implants is low but may attain clinical relevance with raising implant figures worldwide. Patients at risk potentially profit from individualized recall intervals and careful evaluation.

摘要

目的

本研究呈现了一组接受牙种植体周围癌治疗的患者队列,以确定潜在风险因素。

材料与方法

回顾性分析涵盖了1995年至2011年在我科接受种植体周围癌治疗的患者。另外进行的文献检索同样聚焦于种植体周围癌。对获取的文章筛选相关风险因素,并结合我们的患者队列进行讨论。

结果

15例患者接受了种植体周围癌治疗。6例报告有持续饮酒/吸烟情况。9例曾患癌症,其中6例术后接受了放疗。从种植体植入到癌症诊断的平均时间为53.4个月。文献检索发现25例种植体周围癌患者和1例肉瘤患者。8例报告有饮酒/吸烟情况。大多数患者表现出可能发生恶性转化的风险因素:既往癌症(n = 12)、扁平苔藓(n = 4)、放疗(n = 3)和白斑(n = 3)。诊断前的平均时间为51.6个月。

结论

吸烟、饮酒和既往癌症史是种植体周围癌高危患者的特征。性别比例平衡可能表明女性风险更高,且除烟酒消费外还有其他促进致癌的风险因素,这一新颖发现有待更多患者数量的研究证实。

临床意义

牙种植体旁癌症的发病率较低,但随着全球种植体数量的增加可能具有临床相关性。高危患者可能受益于个性化的复诊间隔和仔细评估。

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