放射治疗对头颈部肿瘤患者种植牙的影响

M. Talaat
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摘要

放射治疗用于治疗头颈部癌症患者,作为主要疗法或作为手术或化疗的辅助疗法。放疗会导致一些并发症,这些并发症对患者来说可能非常严重。由于牙齿脱落、美观受损、口干和粘膜炎引起的疼痛和不适,经常会导致功能丧失,这也严重影响了生活质量。牙科学的一项重大进展是骨整合种植体成功地修复和替代失去的牙齿。然而,骨放射性坏死和骨整合失败的风险是这些受照射患者植入治疗的障碍。本文综述的目的是根据不同的研究,主要了解治疗头颈癌患者的放疗是否会影响种植体的成功和存活,并强调可能同时影响种植体的其他相关因素。主要结局指标显示植入物在放疗患者中的存活。大多数研究报道,口腔种植体可以在口腔癌手术后的放射患者中骨整合并保持功能稳定。因此,对于接受放射治疗的头颈癌患者,使用种植体进行康复治疗是一种可行的选择。然而,所有纳入的研究都表明,未放疗患者的生存率明显更高。放疗方式、性别、年龄、种植部位、种植部位的辐射剂量等因素都会影响种植体的存活。需要更多的研究和随机对照试验来做出更准确的判断。
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The Influence of Radiation Therapy on Dental Implantation in Head and Neck Cancer Patients
Radiotherapy is used to treat patients with head and neck cancers as a primary therapy or as an adjuvant to surgery or chemotherapy. Irradiation results in several complications that can be very overwhelming to the patient. Frequently there is loss of function due to tooth loss, compromised aesthetics, pain and discomfort from xerostomia and mucositis, it also significantly impacts the quality of life. A major advance in dentistry is the successful rehabilitation and replacement of lost teeth by osseointegrated implants. However, the risk of osteoradionecrosis and failure of osseointegration are barriers to implant therapy for those irradiated patients. The aim of this review article is to primarily find out whether the radiotherapy used in the treatment of head and neck cancer patients can affect the success and survival of dental implants according to different studies, and also, to highlight some other pertinent factors that may concurrently influence these implantation. The primary outcome measure shows implants survival in irradiated patients. Most of the studies reported that dental implants can osseointegrate and remain functionally stable in irradiated patients following oral cancer surgery. Accordingly, rehabilitation using dental implants is a viable option for head and neck cancer patients receiving radiotherapy. However, all studies included indicated that survival was significantly higher in non-irradiated patients. Factors such as the mode of radiation therapy delivery, gender, age, implant site and radiation dose at the implant site can affect the survival of dental implant. More research and randomized controlled trails are needed for more accurate judgment.
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