Consultant in Restorative Dentistry, Restorative Department, University of Birmingham School of Dentistry, Birmingham Dental Hospital, Birmingham, UK.
Professor of Oral Rehabilitation, Centre for Clinical, Oral and Translational Sciences, King's College London, London, UK.
J Prosthet Dent. 2024 Jul;132(1):278-287. doi: 10.1016/j.prosdent.2022.06.010. Epub 2022 Aug 3.
Literature reporting on the prosthetic survival and complications of implant-retained prostheses in patients with head and neck cancer is sparse.
The purpose of this retrospective study was to present the survival rates and complication-free survival rates of both fixed and removable implant-retained oral prostheses in patients with head and neck cancer while also reporting on the frequency and causes of failure and complications for each prosthesis type.
A retrospective analysis of the prosthetic survival rates and complication-free survival rates of implant-retained oral prostheses and the frequency and causes of failure and complications in patients with head and neck cancer treated in a regional unit from 2012 to 2017 was performed. Differences in categorical and continuous data were assessed for statistical significance by using the Pearson chi-squared test, Fisher exact test, t test, and analysis of variance as appropriate. Cox proportional hazard regression models were fitted to evaluate the association between prostheses type, clinical and medical factors, and the outcomes of survival and complication-free survival. Descriptive statistics were used to analyze the frequency and type of prosthetic complications.
The sample was composed of 153 patients diagnosed with head and neck cancer who had completed implant-retained prosthodontic rehabilitation and had been provided with 221 prostheses. The 5-year survival rate was 87% for maxillary fixed prostheses, 79% for mandibular fixed, 66% for maxillary removable, and 50% for mandibular removable. Hazard ratios were calculated showing that the 5-year survival rate of a mandibular removable prosthesis (HR=5.1; 95% CI 1.60-16.25) (P=.006) was greater than that of a maxillary fixed prosthesis (HR=1.0). The 5-year complication-free survival rate was highest for mandibular fixed prostheses (62%), followed by maxillary fixed (58%), maxillary removable (36%), and mandibular removable prostheses (29%). Hazard ratios showed that the 5-year survival rate of maxillary removable (HR=1.91; 95% CI 1.01-3.66) (P=.048) and mandibular removable prosthesis (HR=2.29; 95% CI 1.23-4.25) (P=.009) was greater than that of a maxillary fixed prosthesis (HR=1.0). Variables of radiotherapy, grafting, age, and sex and their influence on the survival rate and complication-free survival rate were assessed but were not statistically significant.
This evaluation indicated that fixed implant-retained prostheses had a higher 5-year survival rate and 5-year complication-free survival rate than removable implant-retained prostheses in patients with head and neck cancer.
关于头颈部癌症患者使用种植体固位修复体的假体存活率和并发症的文献报道很少。
本回顾性研究的目的是报告头颈部癌症患者固定和可摘种植体固位口腔修复体的存活率和无并发症存活率，并报告每种修复体类型的失败和并发症的频率和原因。
对 2012 年至 2017 年在一个区域单位接受治疗的头颈部癌症患者的种植体固位口腔修复体的存活率和无并发症存活率以及假体失败和并发症的频率和原因进行回顾性分析。使用 Pearson 卡方检验、Fisher 确切检验、t 检验和方差分析适当评估分类和连续数据的差异是否具有统计学意义。使用 Cox 比例风险回归模型评估假体类型、临床和医学因素与生存和无并发症生存结果之间的关系。使用描述性统计分析来分析修复体并发症的频率和类型。
样本由 153 名诊断为头颈部癌症的患者组成，他们完成了种植体支持修复，并获得了 221 个修复体。上颌固定修复体的 5 年存活率为 87%，下颌固定修复体为 79%，上颌可摘修复体为 66%，下颌可摘修复体为 50%。计算的风险比表明，下颌可摘修复体的 5 年存活率（HR=5.1；95%CI 1.60-16.25）（P=.006）大于上颌固定修复体（HR=1.0）。下颌固定修复体的 5 年无并发症存活率最高（62%），其次是上颌固定修复体（58%）、上颌可摘修复体（36%）和下颌可摘修复体（29%）。风险比显示，上颌可摘修复体（HR=1.91；95%CI 1.01-3.66）（P=.048）和下颌可摘修复体（HR=2.29；95%CI 1.23-4.25）（P=.009）的 5 年存活率大于上颌固定修复体（HR=1.0）。评估了放疗、植骨、年龄和性别等变量及其对存活率和无并发症存活率的影响，但没有统计学意义。
本评估表明，与可摘种植体固位修复体相比，固定种植体固位修复体在头颈部癌症患者中具有更高的 5 年存活率和 5 年无并发症存活率。
