Implant rehabilitation in patients irradiated for head and neck cancer: role of Intensity-Moduled Radiotherapy (IMRT) in planning the insertion site
Identifieur interne : 002256 ( Pmc/Corpus ); précédent : 002255; suivant : 002257Implant rehabilitation in patients irradiated for head and neck cancer: role of Intensity-Moduled Radiotherapy (IMRT) in planning the insertion site
Auteurs : Fabrizio Carini ; Valeria Pisapia ; Dario Monai ; Lorena Barbano ; Gianluca PorcaroSource :
- Annali di Stomatologia [ 1824-0852 ] ; 2012.
Abstract
currently, head and neck irradiation is not considered an absolute contraindication for implant placement (
five patients who had been irradiated for head and neck cancer using intensity-modulated radiotherapy (IMRT) were recruited for our study. Surgical procedures were performed following a pre-surgical evaluation of the correct insertion position of implant fixtures. The latter was based on a scrutiny of dose-volume histograms (DVH) developed by a team of experts in medical physics and radiotherapists after dentists had contoured the volumes of interest. Student’s
the percentage of osseointegration was 100%, which supports the usefulness of the adopted technique. A statistically significant difference in stability and crestal bone resorption emerged in the comparison between maxilla and mandible, but not between times of insertion. Moreover, there was a significant correlation between radiation dose and ISQ values: an increase in radiation dose corresponded to a decrease in primary stability. However, the correlation between ISQ values and implant length was not significant as well as that between primary stability and implant diameter.
implantology guided by assessment of absorbed irradiation dose in the site to be rehabilitated can lead both to an increase in implant survival into irradiated tissue bone, and to a reduction in the incidence of ORN. However, both a larger sample size and the development of long-term prospective studies are necessary to validate the described method.
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PubMed: 23285317
PubMed Central: 3512556
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Implant rehabilitation in patients irradiated for head and neck cancer: role of Intensity-Moduled Radiotherapy (IMRT) in planning the insertion site</title><author><name sortKey="Carini, Fabrizio" sort="Carini, Fabrizio" uniqKey="Carini F" first="Fabrizio" last="Carini">Fabrizio Carini</name><affiliation><nlm:aff id="af1-08-20">Research Professor, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Pisapia, Valeria" sort="Pisapia, Valeria" uniqKey="Pisapia V" first="Valeria" last="Pisapia">Valeria Pisapia</name><affiliation><nlm:aff id="af2-08-20">Postgraduate student, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Monai, Dario" sort="Monai, Dario" uniqKey="Monai D" first="Dario" last="Monai">Dario Monai</name><affiliation><nlm:aff id="af3-08-20">Oral Surgery specialist, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Barbano, Lorena" sort="Barbano, Lorena" uniqKey="Barbano L" first="Lorena" last="Barbano">Lorena Barbano</name><affiliation><nlm:aff id="af2-08-20">Postgraduate student, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Porcaro, Gianluca" sort="Porcaro, Gianluca" uniqKey="Porcaro G" first="Gianluca" last="Porcaro">Gianluca Porcaro</name><affiliation><nlm:aff id="af3-08-20">Oral Surgery specialist, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23285317</idno><idno type="pmc">3512556</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512556</idno><idno type="RBID">PMC:3512556</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">002256</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002256</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Implant rehabilitation in patients irradiated for head and neck cancer: role of Intensity-Moduled Radiotherapy (IMRT) in planning the insertion site</title><author><name sortKey="Carini, Fabrizio" sort="Carini, Fabrizio" uniqKey="Carini F" first="Fabrizio" last="Carini">Fabrizio Carini</name><affiliation><nlm:aff id="af1-08-20">Research Professor, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Pisapia, Valeria" sort="Pisapia, Valeria" uniqKey="Pisapia V" first="Valeria" last="Pisapia">Valeria Pisapia</name><affiliation><nlm:aff id="af2-08-20">Postgraduate student, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Monai, Dario" sort="Monai, Dario" uniqKey="Monai D" first="Dario" last="Monai">Dario Monai</name><affiliation><nlm:aff id="af3-08-20">Oral Surgery specialist, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Barbano, Lorena" sort="Barbano, Lorena" uniqKey="Barbano L" first="Lorena" last="Barbano">Lorena Barbano</name><affiliation><nlm:aff id="af2-08-20">Postgraduate student, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author><author><name sortKey="Porcaro, Gianluca" sort="Porcaro, Gianluca" uniqKey="Porcaro G" first="Gianluca" last="Porcaro">Gianluca Porcaro</name><affiliation><nlm:aff id="af3-08-20">Oral Surgery specialist, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</nlm:aff></affiliation></author></analytic><series><title level="j">Annali di Stomatologia</title><idno type="ISSN">1824-0852</idno><idno type="eISSN">1971-1441</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Purpose</title><p>currently, head and neck irradiation is not considered an absolute contraindication for implant placement (<xref ref-type="bibr" rid="b1-08-20">1</xref>), especially due to the transition from conventional to conformal radiotherapy. However, there is a difference in the success rate of implant placement between irradiated and non-irradiated bones (<xref ref-type="bibr" rid="b5-08-20">5</xref>). Successful osseointegration is mainly affected by the total dose of radiation (<xref ref-type="bibr" rid="b6-08-20">6</xref>). The main purpose of this study was to minimize problems related to radiation dose by evaluating in advance the most suitable site for implant insertion on the basis of the mean absorbed dose. Additional aims were: to estimate the appropriate timing for implant insertion in irradiated bones, to analyze the difference in stability between maxilla and mandible, and to evaluate the success of implants with wrinkled microgeometry and increased layer of TiO<sub>2</sub>.</p></sec><sec><title>Materials and methods</title><p>five patients who had been irradiated for head and neck cancer using intensity-modulated radiotherapy (IMRT) were recruited for our study. Surgical procedures were performed following a pre-surgical evaluation of the correct insertion position of implant fixtures. The latter was based on a scrutiny of dose-volume histograms (DVH) developed by a team of experts in medical physics and radiotherapists after dentists had contoured the volumes of interest. Student’s <italic>t</italic> test and Pearson’s correlation test were used for comparison and correlation between the variables considered.</p></sec><sec><title>Results</title><p>the percentage of osseointegration was 100%, which supports the usefulness of the adopted technique. A statistically significant difference in stability and crestal bone resorption emerged in the comparison between maxilla and mandible, but not between times of insertion. Moreover, there was a significant correlation between radiation dose and ISQ values: an increase in radiation dose corresponded to a decrease in primary stability. However, the correlation between ISQ values and implant length was not significant as well as that between primary stability and implant diameter.</p></sec><sec><title>Conclusions</title><p>implantology guided by assessment of absorbed irradiation dose in the site to be rehabilitated can lead both to an increase in implant survival into irradiated tissue bone, and to a reduction in the incidence of ORN. However, both a larger sample size and the development of long-term prospective studies are necessary to validate the described method.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Stomatol (Roma)</journal-id><journal-id journal-id-type="iso-abbrev">Ann Stomatol (Roma)</journal-id><journal-id journal-id-type="publisher-id">Annali_Stomatologia</journal-id><journal-title-group><journal-title>Annali di Stomatologia</journal-title></journal-title-group><issn pub-type="ppub">1824-0852</issn><issn pub-type="epub">1971-1441</issn><publisher><publisher-name>CIC Edizioni Internationali</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23285317</article-id><article-id pub-id-type="pmc">3512556</article-id><article-id pub-id-type="publisher-id">08-20</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Implant rehabilitation in patients irradiated for head and neck cancer: role of Intensity-Moduled Radiotherapy (IMRT) in planning the insertion site</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Carini</surname><given-names>Fabrizio</given-names></name><degrees>MD, DMD</degrees><xref ref-type="aff" rid="af1-08-20">1</xref></contrib><contrib contrib-type="author"><name><surname>Pisapia</surname><given-names>Valeria</given-names></name><degrees>BDS</degrees><xref ref-type="aff" rid="af2-08-20">2</xref></contrib><contrib contrib-type="author"><name><surname>Monai</surname><given-names>Dario</given-names></name><degrees>MDS</degrees><xref ref-type="aff" rid="af3-08-20">3</xref></contrib><contrib contrib-type="author"><name><surname>Barbano</surname><given-names>Lorena</given-names></name><degrees>BDS</degrees><xref ref-type="aff" rid="af2-08-20">2</xref></contrib><contrib contrib-type="author"><name><surname>Porcaro</surname><given-names>Gianluca</given-names></name><degrees>MDS</degrees><xref ref-type="aff" rid="af3-08-20">3</xref><xref ref-type="corresp" rid="c1-08-20"></xref></contrib></contrib-group><aff id="af1-08-20"><label>1</label>Research Professor, University of Milan-Bicocca, Monza (MB), Italy</aff><aff id="af2-08-20"><label>2</label>Postgraduate student, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</aff><aff id="af3-08-20"><label>3</label>Oral Surgery specialist, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy</aff><author-notes><corresp id="c1-08-20"><bold>Corresponding author:</bold> Gianluca Porcaro, Oral Surgery specialist, School of Oral Surgery, University of Milan-Bicocca, Monza (MB), Italy, Phone and Fax: +39 (0) 2333482, E-mail: <email>porcarogianluca@libero.it</email></corresp></author-notes><pub-date pub-type="collection"><season>Apr-Jun</season><year>2012</year></pub-date><pub-date pub-type="epub"><day>14</day><month>11</month><year>2012</year></pub-date><volume>3</volume><issue>2 Suppl</issue><fpage>8</fpage><lpage>20</lpage><permissions><copyright-statement>©2012 CIC Edizioni Internazionali, Rome, Italy</copyright-statement><copyright-year>2012</copyright-year></permissions><abstract><title>Summary</title><sec><title>Purpose</title><p>currently, head and neck irradiation is not considered an absolute contraindication for implant placement (<xref ref-type="bibr" rid="b1-08-20">1</xref>), especially due to the transition from conventional to conformal radiotherapy. However, there is a difference in the success rate of implant placement between irradiated and non-irradiated bones (<xref ref-type="bibr" rid="b5-08-20">5</xref>). Successful osseointegration is mainly affected by the total dose of radiation (<xref ref-type="bibr" rid="b6-08-20">6</xref>). The main purpose of this study was to minimize problems related to radiation dose by evaluating in advance the most suitable site for implant insertion on the basis of the mean absorbed dose. Additional aims were: to estimate the appropriate timing for implant insertion in irradiated bones, to analyze the difference in stability between maxilla and mandible, and to evaluate the success of implants with wrinkled microgeometry and increased layer of TiO<sub>2</sub>.</p></sec><sec><title>Materials and methods</title><p>five patients who had been irradiated for head and neck cancer using intensity-modulated radiotherapy (IMRT) were recruited for our study. Surgical procedures were performed following a pre-surgical evaluation of the correct insertion position of implant fixtures. The latter was based on a scrutiny of dose-volume histograms (DVH) developed by a team of experts in medical physics and radiotherapists after dentists had contoured the volumes of interest. Student’s <italic>t</italic> test and Pearson’s correlation test were used for comparison and correlation between the variables considered.</p></sec><sec><title>Results</title><p>the percentage of osseointegration was 100%, which supports the usefulness of the adopted technique. A statistically significant difference in stability and crestal bone resorption emerged in the comparison between maxilla and mandible, but not between times of insertion. Moreover, there was a significant correlation between radiation dose and ISQ values: an increase in radiation dose corresponded to a decrease in primary stability. However, the correlation between ISQ values and implant length was not significant as well as that between primary stability and implant diameter.</p></sec><sec><title>Conclusions</title><p>implantology guided by assessment of absorbed irradiation dose in the site to be rehabilitated can lead both to an increase in implant survival into irradiated tissue bone, and to a reduction in the incidence of ORN. However, both a larger sample size and the development of long-term prospective studies are necessary to validate the described method.</p></sec></abstract><kwd-group><kwd>implants rehabilitation</kwd><kwd>contouring</kwd><kwd>IMRT</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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