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头颈部肿瘤治疗后患者牙齿及种植体存活率的影响因素——第1部分:牙齿存活情况

Factors Influencing the Survival Rate of Teeth and Implants in Patients after Tumor Therapy to the Head and Neck Region-Part 1: Tooth Survival.

作者信息

Schweyen Ramona, Reich Waldemar, Vordermark Dirk, Kuhnt Thomas, Wienke Andreas, Hey Jeremias

机构信息

Department of Prosthetic Dentistry, University School of Dental Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 16, 06112 Halle, Germany.

Department of Oral and Maxillofacial Plastic Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany.

出版信息

J Clin Med. 2022 Oct 21;11(20):6222. doi: 10.3390/jcm11206222.

Abstract

We aimed to evaluate possible factors influencing the long-term survival of teeth after tumor therapy (TT) to the head and neck region with and without radiation. Between January 2019 and January 2020, patients who underwent TT for head and neck cancer and received dental treatment before and after TT at the Department of Prosthetic Dentistry of the Martin Luther University Halle-Wittenberg were enrolled in the study. Clinical examination with assessment of dental status and stimulated salivary flow rate (SFR) was performed and information about disease progression and therapy was retrieved from medical records. Of 118 patients (male: 70.3%; mean age: 63.2 ± 12.4 years), 95 received radiotherapy (RT), and 47 were administered radio-chemotherapy (RCT). The teeth of irradiated patients exhibited a lower 5-year survival probability (74.2%) than those of non-irradiated patients (89.4%). The risk of loss (RL) after RT increased with nicotine use, presence of intraoral defects, reduced SFR, RCT and regarding mandibular teeth, and decreased with crowning following TT. Lower SFR increased the RL even without RT. Consideration of patient's treatment history, individual risk profile, and clinical findings during the prosthetic planning phase could enable earlier, more targeted dental treatment after TT (e.g., timely crowning).

摘要

我们旨在评估头颈部肿瘤治疗(TT)后,无论有无放疗,影响牙齿长期存活的可能因素。2019年1月至2020年1月期间,在马丁路德大学哈雷 - 维滕贝格大学口腔修复科接受头颈部癌症TT治疗且在TT前后接受牙科治疗的患者纳入本研究。进行了临床检查以评估牙齿状况和刺激唾液流速(SFR),并从病历中获取有关疾病进展和治疗的信息。118例患者(男性:70.3%;平均年龄:63.2±12.4岁)中,95例接受了放疗(RT),47例接受了放化疗(RCT)。接受放疗患者的牙齿5年存活概率(74.2%)低于未接受放疗患者(89.4%)。放疗后的失牙风险(RL)随着吸烟、口腔内缺损的存在、SFR降低、RCT以及下颌牙齿情况而增加,而随着TT后的牙冠修复而降低。即使没有放疗,较低的SFR也会增加RL。在修复计划阶段考虑患者的治疗史、个体风险状况和临床检查结果,可能有助于在TT后更早、更有针对性地进行牙科治疗(例如及时进行牙冠修复)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd5f/9605197/d2730d90c87c/jcm-11-06222-g001.jpg

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