Crestal bone loss around dental implants placed in head and neck cancer patients treated with different radiotherapy techniques: a prospective cohort study
Crestal bone loss around dental implants placed in head and neck cancer patients treated with different radiotherapy techniques: a prospective cohort study
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DOI：
10.1016/j.ijom.2018.10.021
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发表时间：
2019-05-01
影响因子：
2.4
通讯作者：
Pompa, G.
中科院分区：
文献类型：
--
作者：
Papi, P.;Brauner, E.;Pompa, G.
这项前瞻性队列研究的目的是评估放射技术如何影响头颈癌放疗患者的嵴骨丢失和种植体存活率。在本研究中，放疗治疗的类型，即三维适形放疗（3D-CRT）或调强放疗（IMRT），是预测变量。主要结局变量是牙冠骨丢失，记录于种植体放置时以及3、6、12和24个月后。进行描述性分析和方差分析检验；P < 0.05为显著性。32名患者被纳入研究，总共113颗牙种植体被放置在辐照后的残骨上。各组间除6个月后（P = 0.028）骨质流失水平差异无统计学意义（P < 0.05）。种植体累计成活率为94.7%。24个月后，3D-CRT组和IMRT组的平均骨损失分别为0.83 +/- 0.12 mm和0.74 +/- 0.15 mm （P = 0.179）。数据表明，不同的放射技术不影响种植体支持的假肢康复的结果，因为与冠骨丢失和种植体存活有关。然而，需要长期的随访研究来评估放射治疗技术对种植体的真正影响。
The aim of this prospective cohort study was to evaluate how the radiation technique can affect crestal bone loss and the implant survival rate in head and neck cancer patients treated with radiotherapy. In this study, the type of radiotherapy treatment, i.e. three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiation therapy (IMRT), was the predictor variable. The primary outcome variable was crestal bone loss, recorded at implant placement and after 3, 6, 12, and 24 months. A descriptive analysis and ANOVA test were performed; significance was set at P < 0.05. Thirty-two patients were enrolled and a total of 113 dental implants placed in irradiated residual bone. There was no statistically significant difference in crestal bone loss levels between the groups at any of the intervals (P > 0.05), except after 6 months (P = 0.028). The cumulative dental implant survival rate was 94.7%. After 24 months, the mean marginal bone loss was 0.83 +/- 0.12 mm in the 3D-CRT group and 0.74 +/- 0.15 mm in the IMRT group (P = 0.179). The data suggest that the different radiation techniques did not affect the outcomes of implant-supported prosthetic rehabilitation, as related to crestal bone loss and implant survival. However, long-term follow-up studies are necessary to evaluate the real influence of the radiotherapy technique on dental implants.