Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study

BACKGROUND: The aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy. METHODS: We collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone. RESULTS: Implant loss was dependent on the position and location of the implants (P = 0.05-0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determinin

In vitro surface characteristics and impurity analysis of five different commercially available dental zirconia implants

Abstract Background The aim of this study was to assess surface characteristics, element composition, and surface roughness of five different commercially available dental zirconia implants. Five zirconia implants (Bredent whiteSKY™ (I1), Straumann® PURE Ceramic (I2), ceramic.implant vitaclinical (I3), Zeramex® (I4), Ceralog Monobloc M10 (I5)) were evaluated. Methods The evaluation was performed by means of scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and confocal laser scanning microscopy (CLSM). Results The semi-quantitative element composition showed no significant impurity of any implant tested. Both the machined and the rough areas of the investigated implants were predominated by zirconium, oxygen, and carbon. Roughness values (S a) showed highest values for I2 and I5. Conclusions The investigated zirconia implants showed surface characteristics and roughness values close to those of conventionally produced titanium implants, making them a promising alternative. However, zirconia implants have yet to prove themselves in clinical practice and clinical controlled trials

Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh

Abstract Background The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of the patients for the first time. Methods In 17 patients, 21 different regions were augmented with an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany). For the augmentation, a mixture of autologous bone and deproteinized bovine bone mineral (DBBM) or autologous bone alone was used. Reentry with explantation of the TM and simultaneous implantation of 44 implants were performed after 6 months. Preoperative and 6-month postoperative cone beam computed tomographies (CBCT) were performed to measure the gained bone height. Results The success rate for the bone grafting procedure was 100%. Thirty-three percent of cases presented an exposure of the TM during the healing period. However, premature removal of these exposed meshes was not necessary. Exposure rate in augmentations performed with mid-crestal incisions was higher than in augmentations performed with a modified poncho incision (45.5 vs. 20%, p = 0.221). In addition, exposure rates in the maxilla were significantly higher than in the mandible (66.7 vs. 8.3%, p = 0.009). Gender, smoking, periodontal disease, gingiva type, used augmentation material, and used membrane had no significant influence on the exposure rate (p > 0.05). The mean vertical augmentation was 6.5 ± 1.7 mm, and the mean horizontal augmentation was 5.5 ± 1.9 mm. Implant survival rate after a mean follow-up of 12 ± 6 months after reentry was 100%. Conclusion Within the limits of the retrospective character of this study, this study shows for the first time that individualized CAD-CAM TM provide a sufficient and safe augmentation technique, especially for vertical and combined defects. However, the soft tissue handling for sufficient mesh covering remains one of the most critical steps using this technique

The matrix metalloproteinase and insulin-like growth factor system in oral cancer &ndash; a prospective clinical study

Eik Schiegnitz,1 Peer W K&auml;mmerer,2 Holger Sch&ouml;n,1 Christoph G&uuml;lle,1 Manfred Berres,3,4 Keyvan Sagheb,1 Bilal Al-Nawas5 1Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, 2Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre Rostock, Rostock, 3Department of Mathematics and Technology, University of Applied Sciences Koblenz, Remagen, 4Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg University of Mainz, Mainz, 5Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Martin-Luther University Halle, Halle, Germany Aim: The absence of reliable single serum biomarkers for oral premalignant lesion (OPL) and oral squamous cell carcinoma (OSCC) limits early diagnosis, monitoring of advanced disease, and prediction of prognosis. Methods: In this prospective study, serum levels of matrix metalloproteinase (MMP)-2, MMP-3, MMP-13, insulin-like growth factor (IGF)-1, and IGF-binding protein (IGFBP)-3 were measured in 81 untreated OSCC patients, 49 healthy subjects, and 75 individuals with OPLs, and correlated with clinicopathological parameters. Results: Serum levels of MMP-3 were significantly higher in OSCC patients compared to healthy subjects (p=0.004). Mean IGF-1 and IGFBP-3 levels in OSCC patients were significantly lower in healthy subjects (p=0.001 and p&lt;0.001). OSCC patients with an IGF-1 serum value&nbsp;&lt;130&nbsp;ng/mL (median) showed a significantly lower survival rate compared to &ge;130 ng/mL (p=0.049). Combined use of IGF-1 (&lt;130 ng/mL) and IGFBP-3 (&lt;3.1 &micro;g/mL) resulted in a significantly lower 12-month cumulative survival compared to the complementary set (78.5% vs 93.8%; p=0.031). There was a significantly positive correlation between IGF-1 and IGFBP-3 serum values (rs =0.625, p&lt;0.001). Conclusion: This study shows that IGF-1 and IGFBP-3 have a vital role in the pathogenesis of OSCC and indicates for the first time that IGF-1 and IGFBP-3 in combination may be applied as potential tools for prognosis of OSCC. Keywords: oral cancer, OSCC, oral premalignant lesion, serum biomarker, prognosis, IGF, MM