Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: a systematic review and meta-analysis.
Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: a systematic review and meta-analysis.
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DOI：
10.1007/s00784-021-04065-6
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发表时间：
2021-10
影响因子：
3.4
通讯作者：
Schaller B
中科院分区：
文献类型：
--
作者：
Toneatti DJ;Graf RR;Burkhard JP;Schaller B
本系统综述评估种植体存活，计算骨放射性坏死的发生率，并评估辐照头颈癌患者的危险因素。各种数据库（例如，使用Ovid的Medline/Embase）和灰色文献平台使用关键词和主题标题的组合进行搜索。适当时，采用随机效应模型进行meta分析。否则，采用合并分析。660例患者中有425例接受了放疗。总共放置了2602颗种植体，其中1637颗放置在放射患者中。平均随访37.7个月后，未放疗患者种植体存活率为97%(5%置信区间，CI 95.2%, 95% CI 98.3%)，平均随访39.8个月后，放疗患者种植体存活率为91.9% （5% CI 87.7%, 95% CI 95.3%）。11例发生骨放射性坏死，发生率为3% （5% CI 1.6%, 95% CI 4.9%）。影响种植体存活的主要因素是放疗和植骨状态，而影响骨放射性坏死的因素无法通过meta分析确定。我们的数据显示，放疗患者的种植体存活率低于未放疗患者，而骨放射性坏死——虽然罕见——是任何OMF外科医生都应做好准备的严重并发症。成功的关键可能是标准化的患者选择和治疗，以提高护理标准，降低风险和缩短治疗时间。我们的分析提供了进一步的证据，种植体放置是一个可行的治疗选择放疗头颈癌患者的口腔功能下降和良好的长期癌症预后。
This systematic review assesses dental implant survival, calculates the incidence rate of osteoradionecrosis, and evaluates risk factors in irradiated head and neck cancer patients. 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. 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. 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. 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.
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影响因子：
2.9
作者：
Bravata, DM;Olkin, I
通讯作者：
Olkin, I
影响因子：
3.4
作者：
Ettl, Tobias;Junold, Natalie;Meier, Johannes K.
通讯作者：
Meier, Johannes K.
影响因子：
6.3
作者：
Barendregt, Jan J.;Doi, Suhail A.;Vos, Theo
通讯作者：
Vos, Theo
DOI：
10.1007/s00520-020-05431-y
发表时间：
2020-12
期刊：
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
影响因子：
--
作者：
Alberga JM;Korfage A;Bonnema I;Witjes MJH;Vissink A;Raghoebar GM
通讯作者：
Raghoebar GM
影响因子：
--
作者：
Barber, H D;Seckinger, R J;Hayden, R E
通讯作者：
Hayden, R E