Treatment outcome of bone-anchored craniofacial prostheses after tumor surgery.
BACKGROUND
Percutaneous endosseous implants have acquired an important place in the prosthetic rehabilitation of patients with craniofacial defects. The objective of this study was to evaluate the clinical outcome of the use of endosseous implants in the orbital and auricular region as well as to assess the satisfaction of patients with implant-retained craniofacial prostheses after tumor surgery.


METHODS
The clinical outcome and patient satisfaction of implant-retained prostheses in the auricular and orbital region were evaluated in a group of 26 patients with facial defects after tumor surgery by using standardized questionnaires and a clinical assessment. Twelve patients (n = 31 implants) received the implants during ablative tumor surgery, from which 7 patients (n = 20 implants) were treated with radiation therapy after surgery (mean, 65 grays [Gy]). Fourteen patients (n = 44 implants) received the implants after the tumor surgery, from which 5 patients (n = 21 implants) were irradiated after ablative surgery (mean, 54.4 Gy), but before implant placement.


RESULTS
No implants were lost in patients who had not undergone irradiation (100%), whereas 5 implants were lost in the irradiated group (87.8%). The overall implant survival rate was 93.3%. The peri-implant tissues had a healthy appearance, and no cases of osteoradionecrosis occurred. When compared with patients treated with conventional adhesive retained facial prostheses, satisfaction was higher in patients treated with implant-retained facial prostheses.


CONCLUSIONS
From this study, it is concluded that implant-retained facial prostheses are better tolerated than adhesive retained prostheses and offer an improvement in the quality of life. Radiotherapy is not a contraindication for the use of osseointegrated implants in the maxillofacial region, but the loss of implants is higher than in nonirradiated sites.
Schoen
P J
PJ
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, Groningen University Hospital, Groningen, The Netherlands. p.j.schoen@kchir.azg.nl
Raghoebar
G M
GM
van Oort
R P
RP
Reintsema
H
H
van der Laan
B F
BF
Burlage
F R
FR
Roodenburg
J L
JL
Vissink
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D004428:Ear Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020273:Orbital Implants; D009918:Orbital Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019736:Prostheses and Implants; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D016896:Treatment Outcome