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Soft Tissue Management and Prosthetic Rehabilitation in a Tongue Cancer Patient

DOI: 10.1155/2013/475186

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Abstract:

One major challenge in treating head and neck oncologic patients is to achieve an acceptable recovery of physiologic functions compatible with the complete tumor excision. However, after tumor resection, some patients present a surgically altered anatomy incompatible with prosthetic rehabilitation, unless some soft tissue correction is carried out. The aim of the present study is to describe the overall mandibular prosthetic rehabilitation of a postoncologic patient focusing on the possibility of soft tissue correction as a part of the treatment. A 72-year-old woman, who undergone a hemiglossectomy for squamous cell carcinoma several years before, was referred to our department needing a new prosthesis. The patient presented partial mandibular edentulism, defects in tongue mobility, and a bridge of scar tissue connecting one side of the tongue to the alveolar ridge. A diode laser (980?nm) was used to remove the fibrous scar tissue. After reestablishing a proper vestibular depth and soft tissue morphology, two implants were placed in the interforaminal region of the mandible to support an overdenture. 1. Introduction Technical advances in head and neck cancer reconstructive surgery have led surgeons not to consider the complete ablation of neoplasms alone as the focus of treatment planning but rather inseparably from the possibility to return patients, as close as possible, to their premorbid condition. This means the necessity to preserve or restore several essential functions like speech, mastication and deglutition [1, 2]. Dental rehabilitation is an important aspect of such comprehensive treatments, aiming to replace teeth that are missing as a consequence of tumor resection or that patients have already lost. Oral implants offer many advantages in treating edentulous patients who undergone cancer resection when prosthesis has to fit to an altered anatomy [3]. In particular, implant supported overdentures were demonstrated to be a predictable solution for edentulous patients with excellent long-term prognosis, assuring better retention and stability than conventional dentures [4]. While there is no doubt for postoncologic patients about the benefits of an implant supported rehabilitation in terms of stability and retention [5], some questions still remain about the opportunity of placing implants in those patients who received radiation therapy following the surgical treatment due to the possibility of soft tissue complications and low rates of osseointegration reported in the literature [6]. However, if the first decades of the modern implant era

References

[1]  J. A. Logemann, B. R. Pauloski, A. W. Rademaker, and L. A. Colangelo, “Speech and swallowing rehabilitation for head and neck cancer patients,” Oncology, vol. 11, no. 5, pp. 651–659, 1997.
[2]  F. M. S. McConnel, B. R. Pauloski, J. A. Logemann et al., “Functional results of primary closure vs flaps in oropharyngeal reconstruction: a prospective study of speech and swallowing,” Archives of Otolaryngology—Head and Neck Surgery, vol. 124, no. 6, pp. 625–630, 1998.
[3]  R. A. Barrowman, P. R. Wilson, and D. Wiesenfeld, “Oral rehabilitation with dental implants after cancer treatment,” Australian Dental Journal, vol. 56, no. 2, pp. 160–165, 2011.
[4]  D. Laurito, L. Lamazza, M. J. Spink, and A. de Biase, “Tissue-supported dental implant prosthesis (overdenture): the search for the ideal protocol. A literature review,” Annali di Stomatologia, vol. 3, no. 1, pp. 2–10, 2012.
[5]  M. F. W.-Y. Chan, J. P. Hayter, J. I. Cawood, and R. A. Howell, “Oral rehabilitation with implant-retained prostheses following ablative surgery and reconstruction with free flaps,” International Journal of Oral and Maxillofacial Implants, vol. 12, no. 6, pp. 820–827, 1997.
[6]  G. Granstr?m, “Osseointegration in irradiated cancer patients: an analysis with respect to implant failures,” Journal of Oral and Maxillofacial Surgery, vol. 63, no. 5, pp. 579–585, 2005.
[7]  NIH Consensus Development Program, Dental Implants, National Institutes of Health Consensus Development Conference Statement, 1988.
[8]  P. C. Neligan, P. J. Gullane, and R. W. Gilbert, “Functional reconstruction of the oral cavity,” World Journal of Surgery, vol. 27, no. 7, pp. 856–862, 2003.
[9]  G. Romanos and G.-H. Nentwig, “Diode laser (980?nm) in oral and maxillofacial surgical procedures: clinical observations based on clinical applications,” Journal of Clinical Laser Medicine and Surgery, vol. 17, no. 5, pp. 193–197, 1999.
[10]  M. A. Pogrel, “The carbon dioxide laser in soft tissue preprosthetic surgery,” The Journal of Prosthetic Dentistry, vol. 61, no. 2, pp. 203–208, 1989.
[11]  U. Romeo, G. Palaia, A. del Vecchio et al., “Effects of KTP laser on oral soft tissues. An in vitro study,” Lasers in Medical Science, vol. 25, no. 4, pp. 539–543, 2010.
[12]  G. Palaia, G. Gaimari, R. L. Giudice, A. Galanakis, G. Tenore, and U. Romeo, “Excision of an oral angiolipoma by KTP laser: a case report,” Annali di Stomatologia, vol. 2, no. 1-2, pp. 28–31, 2011.
[13]  P. E. Petersen, “Oral cancer prevention and control—the approach of the World Health Organization,” Oral Oncology, vol. 45, no. 4-5, pp. 454–460, 2009.
[14]  K. Z. Siddall, S. N. Rogers, and C. J. Butterworth, “The prosthodontic pathway of the oral cancer patient,” Dental Update, vol. 39, no. 2, pp. 98–106, 2012.
[15]  J. S. Feine, G. E. Carlsson, M. A. Awad et al., “The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients,” Gerodontology, vol. 19, no. 1, pp. 3–4, 2002.
[16]  E. Emami, G. Heydecke, P. H. Rompré, P. de Grandmont, and J. S. Feine, “Impact of implant support for mandibular dentures on satisfaction, oral and general health-related quality of life: a meta-analysis of randomized- controlled trials,” Clinical Oral Implants Research, vol. 20, no. 6, pp. 533–544, 2009.
[17]  W. Att and C. Stappert, “Implant therapy to improve quality of life,” Quintessence International, vol. 34, no. 8, pp. 573–581, 2003.
[18]  J. M. Thomason, “The use of mandibular implant-retained overdentures improve patient satisfaction and quality of life,” Journal of Evidence-Based Dental Practice, vol. 10, no. 1, pp. 61–63, 2010.
[19]  T. Ueda, U. Kremer, J. Katsoulis, and R. Mericske-Stern, “Long-term results of mandibular implants supporting an overdenture: implant survival, failures, and crestal bone level changes,” The International Journal of Oral & Maxillofacial Implants, vol. 26, no. 2, pp. 365–372, 2011.
[20]  G. Granstr?m, “Placement of dental implants in irradiated bone: the case for using hyperbaric oxygen,” Journal of Oral and Maxillofacial Surgery, vol. 64, no. 5, pp. 812–818, 2006.
[21]  A. Buddula, D. Assad, T. Salinas, and Y. Garces, “Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: a retrospective analysis,” Indian Journal of Dental Research, vol. 22, no. 5, pp. 644–648, 2011.
[22]  M. P. Claudy, S. A. Miguens Jr., R. K. Celeste, R. Camara Parente, P. A. Hernandez, and A. N. da Silva Jr., “Time interval after radiotherapy and dental implant failure: systematic review of observational studies and meta-analysis,” Clinical Implant Dentistry and Related Research, 2013.
[23]  K. C. Yerit, M. Posch, M. Seemann et al., “Implant survival in mandibles of irradiated oral cancer patients,” Clinical Oral Implants Research, vol. 17, no. 3, pp. 337–344, 2006.
[24]  R. B. Donoff, “Treatment of the irradiated patient with dental implants: the case against hyperbaric oxygen treatment,” Journal of Oral and Maxillofacial Surgery, vol. 64, no. 5, pp. 819–822, 2006.
[25]  K. Guru, U. K. Manoor, and S. S. Supe, “A comprehensive review of head and neck cancer rehabilitation: physical therapy perspectives,” The Indian Journal of Palliative Care, vol. 18, no. 2, pp. 87–97, 2012.

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