Dental implant treatment in a young woman after marginal mandibulectomy for treatment of mandibular gingival carcinoma: a case report

Prosthetic rehabilitation of a hemimaxillectomy patient using a zygomatic - Corticobasal® implant- supported reconstructive prosthesis: A case report

INTRODUCTION

Rehabilitation of patients with hemimaxillectomy presents a challenge. This case report describes the successful use of zygomatic Corticobasal® implant- supported reconstructed prosthesis.

CLINICAL CASE PRESENTATION

A 20-year-old female patient presented to the clinic following hemimaxillectomy with soft tissue approximation one year ago. The patient was very depressed and reported high aesthetic concern and masticatory inefficiency and required a fixed prosthesis. A multidisciplinary team was formed. A panorama and cone beam CT were acquired. The treatment plan included the construction of an immediately loaded, fixed implant-supported reconstructive prosthesis using 6 Corticobasal® implant (BCS® and ZDI® implant designs, Dr. Ihde Dental AG, Switzerland) and a follow up program. After 3 years in function, the patient presented with 100 % implant survival rate, no complaints, and reported great improvement in esthetics, speech, mastication, and quality of life.

DISCUSSION

The use of zygomatic Corticobasal® implants in this case provides the significant advantages of improving the prosthesis support and the utilization of the strongest zygomatic bone for implant anchorage. Moreover, the use of a metal framework for implant splinting and the monoblock design of the implant reduce the risk of implant/prosthesis overloading, and eliminate the biomechanical complication. Furthermore, the provided fixed prosthesis matched the patient's desire and significantly optimized the patient satisfaction and quality of life.

CONCLUSION

Within the limitation of the study, Corticobasal® implants can be used for rehabilitating hemimaxillectomy patients with optimum peri-implant soft tissue results, reducing risk of infection, achieving high survival rate and significantly improving the patient's aesthetic, functional, and satisfaction.

Prosthetic rehabilitation of segmental mandibulectomy patient using a free fibula flap and Corticobasal implant supported prosthesis: A Case report

INTRODUCTION

Segmental mandibular reconstruction using free fibula flaps and implants is challenging for maxillofacial surgeons and prosthodontists. This case report describes the successful use of Corticobasal implant reconstructive prostheses after a free fibula flap with five years of follow-up.

CLINICAL CASE PRESENTATION

A 24-year-old female presented to the clinic following segmental defect reconstruction using fibula reconstruction, owing to squamous cell carcinoma resection and seeking prosthetic treatment. An intraoral examination revealed a complete healing of the soft tissue. A panoramic radiograph showed a fibula bone graft rehabilitating the left side of the mandible supporting with a reconstructive plate. A multidisciplinary team was formed. A treatment plan included a mandibular reconstructive fixed Corticobasal implant prosthesis supported by eight basal cortical screw implants (BCS®, Dr. Ihde Dental AG, Switzerland) and a follow-up schedule was formulated. After 5-years of function, the implant demonstrated a 100 % survival rate, with no implant loss or fracture, excellent peri-implant soft tissue health, complete union of the bone graft, and a very stable prosthesis. The patient reported significant improvements in aesthetics, mastication, phonation, and self-satisfaction.

DISCUSSION

The multidisciplinary team has significantly improved the treatment outcomes. The prescribed treatment modality provides the patient with a fixed treatment modality, immediate loading, reduces the risk of biological and biomechanical complications, and hence improves the patient's functions and satisfaction.

CONCLUSION

A Corticobasal implant-supported prosthesis can be used in combination with a free fibula flap to reconstruct segmental mandibulectomy patients with a high survival rate and satisfactory aesthetic and functional outcomes.

Rehabilitation of mandibular resected patients using fixed immediately loaded corticobasal implant -supported prostheses. A case series

INTRODUCTION AND IMPORTANCE

Aliments such as congenital conditions, pathological, and iatrogenic circumstances may result in mandibular defects that can severely disturb the patients' oral health, functions (mastication, speech), aesthetics, and quality of life and present a rehabilitating challenge.

CASE PRESENTATION

we present a multidisciplinary treatment approach for three cases presented with mandibular resection as a consequence of cystic, benign, and malignant tumour eradication that were rehabilitated with immediately loaded fixed corticobasal implant-supported prostheses and a follow-up period of 5,5 and 4 years. The reported cases present with excellent implant survival, along with healthy peri-implant tissues, stable prostheses, enhanced speech, chewing ability, aesthetics, superior patient satisfaction, and improved overall self-esteem.

CLINICAL DISCUSSION

A multidisciplinary oral and maxillofacial team is mandatory for the successful rehabilitation of patients with mandibular resection and to restore soft and hard tissue loss. The reported treatment modality offers the patient immediate fixed implant-supported prostheses omitting the need for a bone grafting procedure, with optimum peri-implant tissue health, excellent biomechanical and prosthetic results, and significant improvement in function and satisfaction.

CONCLUSION

Corticobasal fixed implant-supported prostheses can be a reliable treatment modality for mandibular resection, resulting in notable enhancements in the patients' oral health, appearance, mastication, speech, and self-esteem.

Effects of Prophylaxis with Oral Supportive Care for Peri-implantitis in Patients Undergoing Malignancy Chemotherapy

PURPOSE

Dental implants without proper maintenance may lead to serious consequences, such as peri-implantitis. Peri-implantitis in patients undergoing antitumour chemotherapy can negatively affect the prognosis of treatment. The purpose of this study was to examine the association between the onset of peri-implantitis and the effects of oral hygiene management in patients with dental implants undergoing antitumour chemotherapy.

MATERIALS AND METHODS

Twenty-three patients (n = 23) with dental implants who received oral supportive care during malignancy chemotherapy were included. They were categorised into two groups based on the presence of peri-implantitis and were analysed for oral hygiene conditions, maintenance after implant insertion, and adverse effects such as febrile neutropenia. Statistical analysis was performed using the Fisher's exact test and the Mann-Whitney U-test, with p < 0.05 considered statistically significant.

RESULTS

The average number of implants was higher in patients with peri-implantitis; these implants generally did not receive appropriate maintenance. There were statistically significantly fewer peri-implantitis sites in patients receiving continuous implant maintenance therapy than those who did not (p < 0.05). The severity of febrile neutropenia was reduced by dental interventions.

CONCLUSION

Dental intervention before malignancy chemotherapy effectively prevented peri-implantitis and contributed to alleviating febrile neutropenia, even when it was initiated amidst chemotherapy. Dental intervention before chemotherapy seems essential in malignancy patients with dental implants.

Rehabilitation of an irradiated marginal mandibulectomy patient using immediately loaded basal implant-supported fixed prostheses and hyperbaric oxygen therapy: A 2-year follow-up

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Mandibulectomy after oral cancer resection can cause severe facial disfigurement.

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The use of adjunctive radiotherapy may compromise the success rate of reconstructive implant therapy.

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Hyperbaric oxygen therapy (HBO) can repair tissue damage after radiotherapy.

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Basal implants reduces risk of peri-implantitis and osteoradionecrosis.

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This report describes HBO and basal implant treatment for marginal mandibulectomy.

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HBO and basal implants are successful treatment modalities for these patients.

Introduction

The prosthetic rehabilitation of mandibular defects owing to tumor resection is challenging, especially when the patient has undergone subsequent radiotherapy.

Presentation of case

A 46-year old male presented with a marginal mandibular resection. Following surgery, the patient received adjunctive radiation therapy with a total dose of 70 grays. On clinical examination, the patient presented with severely resorbed edentulous jaws, with an anterior marginal mandibular resection and an obliterated vestibular sulcus. The panoramic radiograph showed a hypocellularity of the maxillary and mandibular bones. A multidisciplinary team was formed, and a treatment plan was formulated which involved the construction of a vestibuloplast stent, and the application of 20 hyperbaric oxygen sessions before implant treatment and 10 more sessions after implant insertion. A total of 16 basal cortical screw implants were inserted to support the fixed prostheses, and a vestibuloplasty was performed to improve esthetics. No complications were observed, and at the 2-year follow-up, the patient presented with excellent peri-implant soft tissue health; increased bone-implant contact; and stable, well-functioning prostheses.

Discussion

The construction of a stable, retentive, well-supported removable prosthesis may be complicated in cases of comprehensive mandibular resection. Basal implants can eliminate the need for bone grafting, and reduce the treatment period required for providing a fixed prosthesis.

Conclusion

To our knowledge this is the first evidence reporting the use of fixed basal implant-supported prostheses in irradiated bone, in conjunction with hyperbaric oxygen therapy. A treatment modality that significantly improves the peri-implant tissue health, and ensures an excellent implant-bone contact.

Oral Cancer around Dental Implants Appearing in Patients with\without a History of Oral or Systemic Malignancy: a Systematic Review

Objectives

The purpose of this article is to systematically review the circumstance of oral cancer around osseointegrated dental implants.

Material and Methods

An electronic literature search was conducted through the MEDLINE (PubMed) and EMBASE databases. The search was restricted for articles published during the last 21 years from January 1996 to April 2017 and articles were limited to English language.

Results

A total of 35 articles were reviewed, and 19 of the most relevant articles that are suitable to the criteria were selected. Case reports were analysed when oral cancer was present in patients with dental implants. Finally, the present data included 28 patients.

Conclusions

A direct link between dental implants and oral cancer was not found. It was observed that there were no significant differences in number of incidences of oral cancer between patients with history of malignancy and those without. More research should be made to document such cases. It was noticed that in many cases oral cancer around dental implant present itself as peri-implantitis, correct differential diagnosis is essential in such cases.