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Τετάρτη 29 Μαΐου 2019

A Comparison of Immediate and Delayed Dental Implant Placement in Head and Neck Surgery Patients
Brent Woods, BSc, MBBS, BOralH, GDipDent, FRACDS(OMS) ∗, Michael Schenberg, BDSc, MDSc, FRACDS(OMS) †, Arun Chandu, BDSc, MBBS(Hons), MDSc, PhD, FDSRCS(Eng), FRACDS(OMS), FRCS(Eng) ‡,∗,'Correspondence information about the author BDSc, MBBS(Hons), MDSc, PhD, FDSRCS(Eng), FRACDS(OMS), FRCS(Eng) Arun ChanduEmail the author BDSc, MBBS(Hons), MDSc, PhD, FDSRCS(Eng), FRACDS(OMS), FRCS(Eng) Arun Chandu
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DOI: https://doi.org/10.1016/j.joms.2019.02.007 |
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Abstract
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Purpose
Implant-supported dental prostheses offer numerous benefits for patients after ablative procedures of the head and neck region, including restoration of function, improved self-esteem and body satisfaction, and overall quality of life. Increased experience is emerging with immediate placement of implants at the time of ablative surgery compared with the traditional delayed approach. The authors sought to identify variables affecting survival of osseointegrated dental implants in such patients and to assess the impact of timing of implant insertion (immediate vs delayed) on the time until final prosthesis insertion.

Materials and Methods
Implant survival was assessed based on different factors: immediate versus delayed implants, benign versus malignant disease, postoperative radiotherapy, smoking status, alcohol status, age, 1- versus 2-stage surgery, hyperbaric oxygen therapy, and implant placement into native bone versus into osseous free flap reconstruction. Time to final prosthesis insertion was compared between immediate and delayed implant placement.

Results
The study included 20 patients who received a total of 102 implants (39 immediate, 63 delayed). There were 7 failed implants (overall survival, 93.14%). There was no statistically relevant difference in implant survival between any of the groups assessed. However, there was a significant decrease in time to final prosthesis insertion for those patients receiving immediate implants compared with those who underwent delayed implant placement (321 days; standard error, 46.5 vs 726 days; standard error, 45 days; P < .0001).

Conclusions
Immediate implant placement is an effective approach to the prosthetic rehabilitation of patients undergoing ablative procedures of the jaws, which shortens time to final prosthesis placement without adversely affecting overall implant survival.

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