Abstract
Surgical treatment of malignancies in the oral cavity (tongue, floor of the mouth, alveolus, buccal sulcus, oropharynx) often results in an unfavourable anatomic situation for prosthodontic rehabilitation. The outcome is a severe disturbance of oral functioning despite the improved surgical techniques for reconstruction that are currently available. Radiotherapy, which often is applied postsurgically, worsens oral functioning in many cases. Main problems that may hamper proper prosthodontic rehabilitation of these patients include a severe reduction of the neutral zone, an impaired function of the tongue, and a very poor load-bearing capacity of the remaining soft tissues and mandibular bone. Many of these problems can, at least in part, be diminished by the use of endosseous oral implants. These implants can contribute to the stabilisation of the prostheses and intercept the main part of the occlusal loading. Surgical interventions after radiotherapy are preferably avoided because of compromised heating, which may lead to development of radionecrosis of soft tissues and bone as well as to increased implant toss. If surgical treatment after radiotherapy is indicated, measures to prevent implant toss and development of radionecrosis have to be considered e.g. antibiotic prophylaxis and/or pre-treatment with hyperbaric oxygen (HBO). To avoid this problem, implant insertion during ablative surgery has to be taken into consideration if postoperative radiotherapy is scheduled or possibly will be applied. This approach is in need of a thorough pre-surgical examination and muttidisciptinary consultation for a well-estabtished treatment planning. The primary curative intent of the oncotogical treatment and the prognosis for later prosthodontic rehabilitation have to be taken into account too. (C) 2003 Elsevier Ltd. All rights reserved.
Original language | English |
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Pages (from-to) | 862-871 |
Number of pages | 10 |
Journal | Oral Oncology |
Volume | 40 |
Issue number | 9 |
DOIs | |
Publication status | Published - Oct-2004 |
Keywords
- oncology
- radiotherapy
- mandible
- tongue
- implants
- prosthodontics
- ADJUNCTIVE HYPERBARIC-OXYGEN
- OSSEOINTEGRATED IMPLANTS
- DENTAL IMPLANTS
- ENDOSSEOUS IMPLANTS
- OROMANDIBULAR RECONSTRUCTION
- FREE FLAPS
- IRRADIATED BONE
- CLINICAL-EVALUATION
- ENDOSTEAL IMPLANTS
- TUMOR SURGERY