Advertisement
Journal of Prosthetic Dentistry

Prosthodontic complications during implant-based oral rehabilitation of patients with head and neck cancer

      Abstract

      Statement of problem

      Implant-retained prosthodontic rehabilitation of patients with head and neck cancer is complex. However, the extent of prosthodontic complications has been sparsely reported within the literature.

      Purpose

      The purpose of this retrospective study was to describe the range of complications and issues that affected the oral rehabilitation treatment of patients with head and neck cancer who had completed implant-retained prosthodontic rehabilitation in a tertiary treatment center.

      Material and methods

      A retrospective analysis of complications and their consequences in patients treated in a regional unit from 2012 to 2017 was performed. Descriptive analysis was carried out on the type and frequency of complications and their consequences for the patients’ treatment. Complications were grouped into the following complication types: local and systemic, implant, peri-implant soft tissue, and clinical prosthodontic complications. Implant success and implant survival were also reported.

      Results

      The sample was composed of 163 patients with head and neck cancer who had completed implant-retained prosthodontic rehabilitation. Local and systemic complications affected 8.6% of patients, and peri-implant soft-tissue complications affected 9.8% of patients. Clinical prosthodontic complications leading to repeated clinical or laboratory stages occurred on 48 occasions in 45 patients (27.6% of patients). A total of 763 implants were placed. Implant survival was 95.8% and implant success 94.5%, with a mean follow-up of 42.1 months.

      Conclusions

      This retrospective evaluation indicated that complications arising during the process of implant-retained prosthetic rehabilitation in this patient group were variable and common. Such complications can delay the process of treatment and lead to repeating or restarting clinical and laboratory stages of treatment.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Prosthetic Dentistry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Chan M.F.
        • Hayter J.P.
        • Cawood J.I.
        • Howell R.A.
        Oral rehabilitation with implant-retained prostheses following ablative surgery and reconstruction with free flaps.
        Int J Oral Maxillofac Implants. 1997; 12: 820-827
        • Chang Y.M.
        • Santamaria E.
        • Wei F.C.
        • Chen H.C.
        • Chan C.P.
        • Shen Y.F.
        • et al.
        Primary insertion of osseointegrated dental implants into fibula osteoseptocutaneous free flap for mandible reconstruction.
        Plast Reconstr Surg. 1998; 102: 680-688
        • Smolka K.
        • Kraehenbuehl M.
        • Eggensperger N.
        • Hallermann W.
        • Thoren H.
        • Iizuka T.
        • et al.
        Fibula free flap reconstruction of the mandible in cancer patients: evaluation of a combined surgical and prosthodontic treatment concept.
        Oral Oncol. 2008; 44: 571-581
        • Hundepool A.C.
        • Dumans A.G.
        • Hofer S.O.
        • Fokkens N.J.
        • Rayat S.S.
        • van der Meij E.H.
        • et al.
        Rehabilitation after mandibular reconstruction with fibula free-flap: clinical outcome and quality of life assessment.
        Int J Oral Maxillofac Surg. 2008; 37: 1009-1013
        • Barrowman R.A.
        • Wilson P.R.
        • Wiesenfeld D.
        Oral rehabilitation with dental implants after cancer treatment.
        Aust Dent J. 2011; 56: 160-165
        • Ozan O.
        • Yilmaz B.
        • Pekperdahci T.
        The prosthodontic rehabilitation of malpositioned implants in a patient with basal cell carcinoma: a clinical report.
        J Prosthet Dent. 2008; 99: 174-177
        • Essig H.
        • Rana M.
        • Kokemueller H.
        • von See C.
        • Ruecker M.
        • Tavassol F.
        • et al.
        Pre-operative planning for mandibular reconstruction - a full digital planning workflow resulting in a patient specific reconstruction.
        Head Neck Oncol. 2011; 3: 45
        • Fierz J.
        • Hallermann W.
        • Mericske-Stern R.
        Patients with oral tumors. Part 1: prosthetic rehabilitation following tumor resection.
        Schweiz Monatsschr Zahnmed. 2013; 123: 91-105
        • Katsoulis J.
        • Fierz J.
        • Iizuka T.
        • Mericske-Stern R.
        Prosthetic rehabilitation, implant survival and quality of life 2 to 5 years after resection of oral tumors.
        Clin Implant Dent Relat Res. 2013; 15: 64-72
        • Garrett N.
        • Roumanas E.D.
        • Blackwell K.E.
        • Freymiller E.
        • Abemayor E.
        • Wong W.K.
        • et al.
        Efficacy of conventional and implant-supported mandibular resection prostheses: study overview and treatment outcomes.
        J Prosthet Dent. 2006; 96: 13-24
        • Roumanas E.D.
        • Garrett N.
        • Blackwell K.E.
        • Freymiller E.
        • Abemayor E.
        • Wong W.K.
        • et al.
        Masticatory and swallowing threshold performances with conventional and implant-supported prostheses after mandibular fibula free-flap reconstruction.
        J Prosthet Dent. 2006; 96: 289-297
        • Korfage A.
        • Schoen P.J.
        • Raghoebar G.M.
        • Bouma J.
        • Burlage F.R.
        • Roodenburg J.L.
        • et al.
        Five-year follow-up of oral functioning and quality of life in patients with oral cancer with implant-retained mandibular overdentures.
        Head Neck. 2011; 33: 831-839
        • Hessling S.A.
        • Wehrhan F.
        • Schmitt C.M.
        • Weber M.
        • Schlittenbauer T.
        • Scheer M.
        Implant-based rehabilitation in oncology patients can be performed with high long-term success.
        J Oral Maxillofac Surg. 2015; 73: 889-896
        • Shaw R.J.
        • Sutton A.F.
        • Cawood J.I.
        • Howell R.A.
        • Stat D.L.
        • Brown J.S.
        • et al.
        Oral rehabilitation after treatment for head and neck malignancy.
        Head Neck. 2005; 27: 459-470
        • Teoh K.H.
        • Huryn J.M.
        • Patel S.
        • Halpern J.
        • Tunick S.
        • Wong H.B.
        • et al.
        Implant prosthodontic rehabilitation of fibula free-flap reconstructed mandibles: a Memorial Sloan-Kettering Cancer Center review of prognostic factors and implant outcomes.
        Int J Oral Maxillofac Implants. 2005; 20: 738-746
        • Vosselman N.
        • Alberga J.
        • Witjes M.H.J.
        • Raghoebar G.M.
        • Reintsema H.
        • Vissink A.
        • et al.
        Prosthodontic rehabilitation of head and neck cancer patients-challenges and new developments.
        Oral Dis. 2021; 27: 64-72
        • Kovács A.F.
        The fate of osseointegrated implants in patients following oral cancer surgery and mandibular reconstruction.
        Head Neck. 2000; 22: 111-119
        • Mericske-Stern R.
        • Perren R.
        • Raveh J.
        Life table analysis and clinical evaluation of oral implants supporting prostheses after resection of malignant tumors.
        Int J Oral Maxillofac Implants. 1999; 14: 673-680
        • Schultes G.
        • Gaggl A.
        • Kärcher H.
        Stability of dental implants in microvascular osseous transplants.
        Plast Reconstr Surg. 2002; 109: 916-924
        • Blake F.
        • Bubenheim M.
        • Heiland M.
        • Pohlenz P.
        • Schmelzle R.
        • Gbara A.
        Retrospective assessment of the peri-implant mucosa of implants inserted in reanastomosed or free bone grafts from the fibula or iliac crest.
        Int J Oral Maxillofac Implants. 2008; 23: 1102-1108
        • Wang F.
        • Huang W.
        • Zhang C.
        • Sun J.
        • Kaigler D.
        • Wu Y.
        Comparative analysis of dental implant treatment outcomes following mandibular reconstruction with double-barrel fibula bone grafting or vertical distraction osteogenesis fibula: a retrospective study.
        Clin Oral Implants Res. 2015; 26: 157-165
        • Cuesta-Gil M.
        • Ochandiano Caicoya S.
        • Riba-García F.
        • Duarte Ruiz B.
        • Navarro Cuéllar C.
        • Navarro Vila C.
        Oral rehabilitation with osseointegrated implants in oncologic patients.
        J Oral Maxillofac Surg. 2009; 67: 2485-2496
        • Fang W.
        • Liu Y.P.
        • Ma Q.
        • Liu B.L.
        • Zhao Y.
        Long-term results of mandibular reconstruction of continuity defects with fibula free flap and implant-borne dental rehabilitation.
        Int J Oral Maxillofac Implants. 2015; 30: 169-178
        • Nayar S.
        Current concepts and novel techniques in the prosthodontic management of head and neck cancer patients.
        Br Dent J. 2019; 226: 725-737
        • Laverty D.P.
        • Addison O.
        • Wubie B.A.
        • Heo G.
        • Parmar S.
        • Martin T.
        • et al.
        Outcomes of implant-based oral rehabilitation in head and neck oncology patients-a retrospective evaluation of a large, single regional service cohort.
        Int J Implant Dent. 2019; 5: 5-8