Oral rehabilitation of the cancer patient: A formidable challenge

Abstract

Rehabilitation of oral functions following surgery on the jaws is a goal that is often difficult to achieve. Removable dentures supported by remaining teeth or gum are often unstable and seldom satisfactory. On the other hand, endosseous (dental) implants offer a mechanism to provide stability to the dentures. This review, discusses factors related to the tumor, patient, treatment, and physicians which impact upon the feasibility and success of dental implants in patients with oral cancer.

Oral health‐related quality of life, oral aesthetics and oral function in head and neck cancer patients after oral rehabilitation

“…The survival of implants in irradiated HNC patients have been investigated and may be a successful part of the oral rehabilitation . However, the general opinion is still not to perform surgery on irradiated patients including insertion of implants because of the risk of developing osteoradionecrosis but opinions on this topic are divergent in the literature …”

“…It has been suggested that use of implant-supported prostheses may improve the outcome of oral rehabilitation in HNC patients. 12 By using implants, the prosthesis could be stabilised and lack of saliva and poor retention may not be a great obstacle. This could in turn improve the function of the prosthesis and thus the OHRQoL.…”

“…27 However, the general opinion is still not to perform surgery on irradiated patients including insertion of implants because of the risk of developing osteoradionecrosis but opinions on this topic are divergent in the literature. 12,28 In our study, we did not register if the patients had implant-supported prosthesis or conventional prosthesis. Also, we did not regis- not included which may have influenced the findings.…”

“…The rehabilitation can be challenging because of the prior surgery, reconstruction and the side effects from the oncologic treatment, including mucositis, hyposalivation, xerostomia, fibrosis, trismus and osteoradionecrosis . The dental treatment after radiation therapy in the head and neck area has limitations since there is a risk of initiating osteoradionecrosis in the irradiated bone, and therefore extractions, surgery and insertion of dental implants are generally not recommended in this patient group after the radiation therapy has started …”

Postimplantation radiation therapy in head and neck cancer patients: Literature review

“…Many authors and systematic reviews have already shown good outcomes of implant surgery and dental implant‐supported prosthetics in patients with HNC. High implant survival rates and restoration of a good quality of life have been reported . After facial RT, it is now commonly thought that oral implant surgery can be performed at the irradiated sites .…”