Immediate dental implants in fibula free flaps to reconstruct the mandible: A pilot study of the short-term effects on radiotherapy for patients with head and neck cancer.
Immediate dental implants in fibula free flaps to reconstruct the mandible: A pilot study of the short-term effects on radiotherapy for patients with head and neck cancer.
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DOI：
10.1111/cid.12870
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发表时间：
2020-02
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
--
作者：
目前的初步研究旨在报告短期经验，因为它与急性放射治疗结局有关，比较了腓骨游离瓣重建中即刻牙种植体的患者与腓骨游离瓣重建中未使用牙种植体的患者的历史队列。对2015年至2018年在三级癌症中心接受下颌骨节段切除术、腓骨游离皮瓣重建和辅助放疗（n=10）和不立即种植牙（n=10）的患者进行了回顾性审查（IRB #17-271）。记录术后并发症的发生率、开始放射治疗的时间、急性毒性的发生和患者报告的结局数据。对辐射计划进行评估，以确定下颌骨和口腔接受的平均和最大剂量以及全球辐射热点的位置。两个队列的术后并发症数量相似，病例组3起事件，对照组2起事件。与对照组相比，种植牙患者的牙关紧闭症较少。对放射治疗计划的评价显示，两组的中位辐射全球热点相似。目前的研究表明，牙科植入物的存在不会增加手术后或放射治疗期间并发症的风险。植入物不会改变辐射剂量测定，但似乎确实对早期患者的生活质量产生积极影响。虽然需要更长时间的随访，但基于这一初步经验，应该为癌症患者提供这种类型的重建，而不必担心影响放射时间或输送。
The current pilot study aims to report short-term experience as it relates to acute radiotherapy treatment outcomes comparing patients with immediate dental implants in fibula free flap reconstructions to a historical cohort of patients with fibula free flap reconstructions without dental implants. A retrospective review of patients who underwent segmental mandibulectomy, reconstruction with fibula free flaps, and adjuvant radiotherapy with (n=10) and without immediate dental implants (n=10) at a tertiary cancer center from 2015 to 2018 was performed (IRB #17–271). Incidence of post-operative complications, time to initiation of radiation therapy, development of acute toxicity, and patient reported outcome data were recorded. The radiation plans were evaluated to identify the mean and maximum doses received by the mandible and oral cavity as well as the locations of radiation global hot spots. There was a similar number of post-operative complications in both cohorts, with 3 events in the case group and 2 events in the control group. Patients with dental implants reported less trismus than control patients. Evaluation of the radiation treatment plans revealed similar median radiation global hot spots in both groups. The current study suggests that the presence of dental implants does not increase the risk of complications following surgery or during radiation treatment. Implants do not alter radiation dosimetry but do appear to positively impact early patient quality of life. Although longer follow-up is needed, based on this preliminary experience, cancer patients should be offered this type of reconstruction without fear of impacting radiation timing or delivery.
DOI：
10.1097/gox.0000000000002100
发表时间：
2019-01-01
影响因子：
1.5
作者：
Allen, Robert J., Jr.;Shenaq, Deana S.;Matros, Evan
通讯作者：
Matros, Evan
影响因子：
3.6
作者：
Cordeiro, PG;Disa, JJ;Hu, QY
通讯作者：
Hu, QY
影响因子：
3
作者：
ZLOTOLOW, IM;HURYN, JM;HIDALGO, DA
通讯作者：
HIDALGO, DA