Toneatti, Daniel Jan (2021). Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: a systematic review and meta-analysis. (Thesis). Universität Bern, Bern
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Abstract
Objectives: This systematic review assesses dental implant survival, calculates the incidence rate of osteoradionecrosis, and evaluates risk factors in irradiated head and neck cancer patients. Materials and methods: Various databases (e.g., Medline/Embase using Ovid) and gray literature platforms were searched using a combination of keywords and subject headings. When appropriate, meta-analysis was carried out using a random effects model. Otherwise, pooled analysis was applied. Results: A total of 425 of the 660 included patients received radiotherapy. In total, 2602 dental implants were placed, and 1637 were placed in irradiated patients. Implant survival after an average follow-up of 37.7 months was 97% (5% confidence interval, CI 95.2%, 95% CI 98.3%) in nonirradiated patients and 91.9% (5% CI 87.7%, 95% CI: 95.3%) after an average follow-up of 39.8 months in irradiated patients. Osteoradionecrosis occurred in 11 cases, leading to an incidence of 3% (5% CI 1.6%, 95% CI 4.9%). The main factors impacting implant survival were radiation and grafting status, while factors influencing osteoradionecrosis could not be determined using meta-analysis. Conclusion: Our data show that implant survival in irradiated patients is lower than in nonirradiated patients, and osteoradionecrosis is—while rare—a serious complication that any OMF surgeon should be prepared for. The key to success could be a standardized patient selection and therapy to improve the standard of care, reduce risks and shorten treatment time. Clinical relevance: Our analysis provides further evidence that implant placement is a feasible treatment option in irradiated head and neck cancer patients with diminished oral function and good long-term cancer prognosis.
| Item Type: | Thesis |
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| Dissertation Type: | Single |
| Date of Defense: | 20 October 2021 |
| Subjects: | 600 Technology > 610 Medicine & health |
| Institute / Center: | 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Craniomaxillofacial Surgery |
| Depositing User: | Hammer Igor |
| Date Deposited: | 24 Jan 2023 15:20 |
| Last Modified: | 24 Jan 2023 23:25 |
| URI: | https://boristheses.unibe.ch/id/eprint/4029 |
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