Pompa Giorgio, Saccucci Matteo, Di Carlo Gabriele, Brauner Edoardo, Valentini Valentino, Di Carlo Stefano, Gentile Tina, Guarino Giorgio, Polimeni Antonella
Department of Oral and Maxillofacial Science, Sapienza University of Rome, Via Caserta 272/A, Rome, Italy.
BMC Oral Health. 2015 Jan 20;15:5. doi: 10.1186/1472-6831-15-5.
The aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy.
We collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone.
Implant loss was dependent on the position and location of the implants (P = 0.05-0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determining survival. We observed significantly better outcomes when the implant was not loaded until at least 6 months after placement.
Although the retrospective design of this study could be affected by selection and information biases, we conclude that a delayed loading protocol will give the best chance of implant osseointegration, stability and, ultimately, effective dental rehabilitation.
本回顾性研究的目的是评估在接受或未接受放疗的口腔癌患者中，切除术后植入牙种植体的存活率。
我们收集了2007年至2012年间34例（22例女性，12例男性；平均年龄：51±19岁）患有口腔恶性肿瘤并接受了切除手术且接受牙种植体修复的患者的数据。12例患者在植入种植体前接受了术后放疗（小于50Gy）。在接受放疗和未接受放疗的剩余骨中，共植入了144颗钛种植体，植入间隔至少为12个月。
种植体的丢失取决于种植体的位置（P = 0.05 - 0.1）。此外，种植体的存活取决于患者是否接受了放疗。这一结果具有高度统计学意义（P < 0.01）。种植体是否负重是决定其存活的另一个高度显著（P < 0.01）的因素。我们观察到，种植体在植入后至少6个月才负重时，效果明显更好。
尽管本研究的回顾性设计可能受到选择偏倚和信息偏倚的影响，但我们得出结论，延迟负重方案将为种植体骨整合、稳定性以及最终有效的牙齿修复提供最佳机会。
