Zobu implantācija mutes vēža pacientiem: par un pret
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Date
2021
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Mutes dobuma ļaundabīgie audzēji ir aktuāla un pieaugoša globāla problēma, tādēļ zobārstniecības speciālistiem ir labi jāpārzina gan metodes, kas ļauj veiksmīgi rehabilitēt onkoloģiskos pacientus, uzlabojot viņu dzīves kvalitāti, gan faktorus, kas var ietekmēt orālās rehabilitācijas rezultātus.
Konvencionālo protētisko konstrukciju izgatavošana pēc mutes vēža ārstēšanas bieži ir apgrūtināta vai pat neiespējama izmainītas mutes dobuma anatomijas un fizioloģijas dēļ, tāpēc zobu implantācija šiem pacientiem ir labs risinājums.
Darba mērķis ir noteikt un izvērtēt potenciālos riska faktorus, kas ietekmē zobu implantu prognozi un dzīvildzi mutes vēža pacientiem, vienlaicīgi identificējot kontrindikācijas zobu implantācijai šai pacientu grupai.
Pētījums ir uz zinātniskiem rakstiem balstīts literatūras apskats. Kopumā literatūras pārskatā izmantotas 59 publikācijas, kas publicētas laika posmā no 2001. gada aprīļa līdz 2020. gada februārim.
Darbā analizēti galvenie potenciālie zobu implantāciju ietekmējošie riska faktori mutes vēža pacientiem, īpaši uzsvērot staru terapijas, implanta lokalizācijas vietas, kaula tipa, implantācijas laika un ķīmijterapijas ietekmi uz zobu implantu oseointegrāciju un dzīvildzi.
Analizējot jaunāko zinātnisko literatūru, secināts, ka būtiskākais faktors, kas ietekmē implanta prognozi un dzīvildzi mutes vēža pacientiem, ir staru terapija. Implanta lokalizācijai (augšžoklis/apakšžoklis), kaula tipam un implantācijas laikam ir sekundāra nozīme. Patiesā ķīmijterapijas ietekme uz zobu implantu oseointegrāciju un dzīvildzi mutes vēža pacientiem joprojām nav pierādīta; pieejamie randomizētie dati ir limitēti un ar mazu pacientu skaitu. Pētījuma rezultātā apzinātas arī kontrindikācijas zobu implantācijai mutes vēža pacientiem.
Lai gan pastāv virkne faktoru, kas var negatīvi ietekmēt oseointegrēto implantu dzīvildzi mutes vēža pacientiem, ārstēšanas plāns, kas balstās uz šo riska faktoru analīzi, kā arī precīzas un pamatotas ķirurģiskās manipulācijas ir priekšnosacījums veiksmīgai un ilglaicīgai implantu un uz tiem balstītu konstrukciju kalpošanai mutes dobumā.
Number of patients suffering from cancer of the oral cavity is increasing worldwide. Therefore, it is of great importance that specialists who work in the dental health field are familiar with methods of oral cavity rehabilitation in order to improve the quality of life among oral cancer patients. In addition, specialists should be aware of risk factors that could affect the results of the rehabilitation outcome. Treatment of the oral cancer results in changes of anatomical structures and physiological functions of the oral cavity and in some cases satisfactory rehabilitation of aesthetics and function cannot be achieved with conventional prostheses, in such cases dental implants is one of the best solutions for these patients. The aim of the paper is to determine and evaluate the potential risk factors affecting the prognosis and survival of dental implants for patients affected by oral cancer and to identify contraindications for implant placement to patients of this group. The research is based on a literature review. There are 59 scientific publications reviewed, being published as from April, 2001 up to February, 2020. Main factors that have a direct effect on osseointegration, survival and failure of dental implants in oral cancer patients are radiation therapy, implant location, bone type, the time of implantation and chemotherapy. Results of this research suggest that the most important factor that affects the prognosis and survival of dental implants in patients affected by oral cancer is radiation therapy. The localisation of the implant (maxilla/mandible), type of bone and time of implant placement are of secondary importance. The overall effect of chemotherapy on the osseointegration of dental implants has not been scientifically proven yet. The randomised data available is limited and done on a small number of participants. In addition, this research outlines contraindications of dental implants for oral cancer patients. Although there are numerous factors that can negatively affect the longevity of the osseointegrated implants for oral cancer patients, a treatment plan based on the analysis of these risk factors as well as precise surgical procedures are preconditions for an enhanced survival of dental implants and implant-supported intra-oral prostheses.
Number of patients suffering from cancer of the oral cavity is increasing worldwide. Therefore, it is of great importance that specialists who work in the dental health field are familiar with methods of oral cavity rehabilitation in order to improve the quality of life among oral cancer patients. In addition, specialists should be aware of risk factors that could affect the results of the rehabilitation outcome. Treatment of the oral cancer results in changes of anatomical structures and physiological functions of the oral cavity and in some cases satisfactory rehabilitation of aesthetics and function cannot be achieved with conventional prostheses, in such cases dental implants is one of the best solutions for these patients. The aim of the paper is to determine and evaluate the potential risk factors affecting the prognosis and survival of dental implants for patients affected by oral cancer and to identify contraindications for implant placement to patients of this group. The research is based on a literature review. There are 59 scientific publications reviewed, being published as from April, 2001 up to February, 2020. Main factors that have a direct effect on osseointegration, survival and failure of dental implants in oral cancer patients are radiation therapy, implant location, bone type, the time of implantation and chemotherapy. Results of this research suggest that the most important factor that affects the prognosis and survival of dental implants in patients affected by oral cancer is radiation therapy. The localisation of the implant (maxilla/mandible), type of bone and time of implant placement are of secondary importance. The overall effect of chemotherapy on the osseointegration of dental implants has not been scientifically proven yet. The randomised data available is limited and done on a small number of participants. In addition, this research outlines contraindications of dental implants for oral cancer patients. Although there are numerous factors that can negatively affect the longevity of the osseointegrated implants for oral cancer patients, a treatment plan based on the analysis of these risk factors as well as precise surgical procedures are preconditions for an enhanced survival of dental implants and implant-supported intra-oral prostheses.
Description
Zobārstniecība
Dentistry
Veselības aprūpe
Health Care
Dentistry
Veselības aprūpe
Health Care
Keywords
zobu implanti, mutes vēzis, implanta izdzīvošana, implanta neveiksme, oseointegrācija, dental implants, oral cancer, implant survival, implant failure, osseointegration