[Prosthetic-implantology defect treatment concept for oral rehabilitation of the mandibular area after tumor treatment].
Between 1988 and 1997, tumor resection was carried out in 18 irradiated patients group 1: 36-72 Gy. 83 implants) and 22 nonirradiated patients (group 2: 92 implants) in the mandible and floor of the mouth, and these patients subsequently underwent mandibular endosseous implant rehabilitation. A total of 23 patients were treated with exclusively implant-supported prostheses, and 16 with implant tissue-supported constructions. Between 1988 and 1991, group 1 and 2 patients received implant tissue-supported prostheses (using two to four implants). Due to prosthesis-related pressure lesions, the strategy has now been changed. Since 1992, group 1 patients have received exclusively implant-supported prostheses (using five to six implants), while group 2 patients have received implant tissue-supported constructions (using four implants). Special criteria for the success of implant-supported maxillofacial prosthetics were drawn up. With an average follow-up period of 37 months 160 fixtures (91%) were clinically osseointegrated. Both types of restoration provided sufficient oral rehabilitation. However, only completely implant-supported prostheses avoided soft tissue ulcers. The overall success rate was about 77% after 7 years in group 1 and about 87% after 9 years in group 2. With regard to implants placed after strategy change, the 5-year success rate was approximately 86% (group 1) and 94% (group 2). In irradiated patients, an exclusively implant-supported prosthesis without any mucosal contact (thus avoiding soft tissue ulcers with a potential to develop osteoradionecrosis) should therefore be fabricated. Implant tissue-supported restoration is also possible in nonirradiated oral cancer patients.
Universitätsklinik für Gesichts- und Kieferchirurgie, Kliniken Essen-Mitte.
T
T
Weischer
C
C
Mohr
R
R
Kling
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003758:Dental Implantation, Endosseous; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000534:rehabilitation*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000534:rehabilitation*; D009065:Mouth Rehabilitation; D016896:Treatment Outcome
Defektprothetisch-implantologisches Behandlungskonzept zur oralen Rehabilitation der unteren Mundhöhlenetage nach Tumorbehandlung.