The Journal of Advanced Prosthodontics

The Korean Academy of Prosthodonitics (대한치과보철학회)
권호 표지
DOI QR코드

DOI QR Code

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction

  • Doh, Re-Mee (Department of Advanced General Dentistry, Dankook University College of Dentistry) ;
  • Kim, Sungtae (Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry) ;
  • Keum, Ki Chang (Department of Radiation Oncology, Yonsei University College of Medicine) ;
  • Kim, Jun Won (Department of Radiation Oncology, Yonsei University College of Medicine) ;
  • Shim, June-Sung (Department of Prosthodontics, Yonsei University College of Dentistry) ;
  • Jung, Han-Sung (Division in Anatomy and Development Biology, Department of Oral Biology, Yonsei University College of Dentistry) ;
  • Park, Kyeong-Mee (Department of Advanced General Dentistry, Yonsei University College of Dentistry) ;
  • Chung, Moon-Kyu (Division in Anatomy and Development Biology, Department of Oral Biology, Yonsei University College of Dentistry)
  • Received : 2016.02.29
  • Accepted : 2016.08.08
  • Published : 2016.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

Keywords

References

  1. Schepers RH, Slagter AP, Kaanders JH, van den Hoogen FJ, Merkx MA. Effect of postoperative radiotherapy on the functional result of implants placed during ablative surgery for oral cancer. Int J Oral Maxillofac Surg 2006;35:803-8. https://doi.org/10.1016/j.ijom.2006.03.007
  2. Dreizen S, Daly TE, Drane JB, Brown LR. Oral complications of cancer radiotherapy. Postgrad Med 1977;61:85-92.
  3. Granstrom G, Tjellstrom A. Effects of irradiation on osseointegration before and after implant placement: a report of three cases. Int J Oral Maxillofac Implants 1997;12:547-51.
  4. Sclaroff A, Haughey B, Gay WD, Paniello R. Immediate mandibular reconstruction and placement of dental implants. At the time of ablative surgery. Oral Surg Oral Med Oral Pathol 1994;78:711-7. https://doi.org/10.1016/0030-4220(94)90085-X
  5. Schoen PJ, Reintsema H, Raghoebar GM, Vissink A, Roodenburg JL. The use of implant retained mandibular prostheses in the oral rehabilitation of head and neck cancer patients. A review and rationale for treatment planning. Oral Oncol 2004;40:862-71. https://doi.org/10.1016/j.oraloncology.2003.08.024
  6. Kwakman JM, Freihofer HP, van Waas MA. Osseointegrated oral implants in head and neck cancer patients. Laryngoscope 1997;107:519-22. https://doi.org/10.1097/00005537-199704000-00016
  7. Brasseur M, Brogniez V, Gregoire V, Reychler H, Lengele B, D'Hoore W, Nyssen-Behets C. Effects of irradiation on bone remodelling around mandibular implants: an experimental study in dogs. Int J Oral Maxillofac Surg 2006;35:850-5. https://doi.org/10.1016/j.ijom.2006.03.016
  8. Brogniez V, D'Hoore W, Grégoire V, Munting E, Reychler H. Implants placed in an irradiated dog mandible: a morphometric analysis. Int J Oral Maxillofac Implants 2000;15:511-8.
  9. Brogniez V, Nyssen-Behets C, Gregoire V, Reychler H, Lengele B. Implant osseointegration in the irradiated mandible. A comparative study in dogs with a microradiographic and histologic assessment. Clin Oral Implants Res 2002;13:234-42. https://doi.org/10.1034/j.1600-0501.2002.130302.x
  10. Schön R, Ohno K, Kudo M, Michi K. Peri-implant tissue reaction in bone irradiated the fifth day after implantation in rabbits: histologic and histomorphometric measurements. Int J Oral Maxillofac Implants 1996;11:228-38.
  11. Weinlaender M, Beumer J 3rd, Kenney EB, Lekovic V, Holmes R, Moy PK, Plenk H Jr. Histomorphometric and fluorescence microscopic evaluation of interfacial bone healing around 3 different dental implants before and after radiation therapy. Int J Oral Maxillofac Implants 2006;21:212-24.
  12. Futami T, Fujii N, Ohnishi H, Taguchi N, Kusakari H, Ohshima H, Maeda T. Tissue response to titanium implants J Adv Prosthodont 2016;8:363-71 in the rat maxilla: ultrastructural and histochemical observations of the bone-titanium interface. J Periodontol 2000;71:287-98. https://doi.org/10.1902/jop.2000.71.2.287
  13. Del Signore A, De Sanctis V, Di Mauro E, Negri R, Perrone-Capano C, Paggi P. Gene expression pathways induced by axotomy and decentralization of rat superior cervical ganglion neurons. Eur J Neurosci 2006;23:65-74. https://doi.org/10.1111/j.1460-9568.2005.04520.x
  14. Jegoux F, Malard O, Goyenvalle E, Aguado E, Daculsi G. Radiation effects on bone healing and reconstruction: interpretation of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:173-84. https://doi.org/10.1016/j.tripleo.2009.10.001
  15. Kenzora JE, Steele RE, Yosipovitch ZH, Glimcher MJ. Experimental osteonecrosis of the femoral head in adult rabbits. Clin Orthop Relat Res 1978;130:8-46.
  16. Kim JH, Park YB, Li Z, Shim JS, Moon HS, Jung HS, Chung MK. Effect of alendronate on healing of extraction sockets and healing around implants. Oral Dis 2011;17:705-11. https://doi.org/10.1111/j.1601-0825.2011.01829.x
  17. Andersson G, Andreasson L, Bjelkengren G. Oral implant rehabilitation in irradiated patients without adjunctive hyperbaric oxygen. Int J Oral Maxillofac Implants 1998;13:647-54.
  18. August M, Bast B, Jackson M, Perrott D. Use of the fixed mandibular implant in oral cancer patients: a retrospective study. J Oral Maxillofac Surg 1998;56:297-301. https://doi.org/10.1016/S0278-2391(98)90102-1
  19. Brogniez V, Lejuste P, Pecheur A, Reychler H. Dental prosthetic reconstruction of osseointegrated implants placed in irradiated bone. Int J Oral Maxillofac Implants 1998;13:506-12.
  20. Costantino PD, Friedman CD, Steinberg MJ. Irradiated bone and its management. Otolaryngol Clin North Am 1995;28:1021-38.
  21. Marx RE, Johnson RP. Studies in the radiobiology of osteoradionecrosis and their clinical significance. Oral Surg Oral Med Oral Pathol 1987;64:379-90. https://doi.org/10.1016/0030-4220(87)90136-8
  22. Jacobsson MG, Jonsson AK, Albrektsson TO, Turesson IE. Short- and long-term effects of irradiation on bone regeneration. Plast Reconstr Surg 1985;76:841-50. https://doi.org/10.1097/00006534-198512000-00006
  23. Granstrom G. Osseointegration in irradiated cancer patients: an analysis with respect to implant failures. J Oral Maxillofac Surg 2005;63:579-85. https://doi.org/10.1016/j.joms.2005.01.008
  24. Jacobsson M, Albrektsson T, Turesson I. Dynamics of irradiation injury to bone tissue. A vital microscopic investigation. Acta Radiol Oncol 1985;24:343-50. https://doi.org/10.3109/02841868509136063
  25. Rebaudi A, Koller B, Laib A, Trisi P. Microcomputed tomographic analysis of the peri-implant bone. Int J Periodontics Restorative Dent 2004;24:316-25.
  26. Stoppie N, van der Waerden JP, Jansen JA, Duyck J, Wevers M, Naert IE. Validation of microfocus computed tomography in the evaluation of bone implant specimens. Clin Implant Dent Relat Res 2005;7:87-94. https://doi.org/10.1111/j.1708-8208.2005.tb00051.x
  27. Todisco M, Trisi P. Bone mineral density and bone histomorphometry are statistically related. Int J Oral Maxillofac Implants 2005;20:898-904.
  28. Verdonck HW, Meijer GJ, Nieman FH, Stoll C, Riediger D, de Baat C. Quantitative computed tomography bone mineral density measurements in irradiated and non-irradiated minipig alveolar bone: an experimental study. Clin Oral Implants Res 2008;19:465-8. https://doi.org/10.1111/j.1600-0501.2007.01496.x
  29. Aitasalo K. Bone tissue response to irradiation and treatment model of mandibular irradiation injury. An experimental and clinical study. Acta Otolaryngol Suppl 1986;428:1-54.
  30. Fujii N, Kusakari H, Maeda T. A histological study on tissue responses to titanium implantation in rat maxilla: the process of epithelial regeneration and bone reaction. J Periodontol 1998;69:485-95. https://doi.org/10.1902/jop.1998.69.4.485
  31. Haga M, Fujii N, Nozawa-Inoue K, Nomura S, Oda K, Uoshima K, Maeda T. Detailed process of bone remodeling after achievement of osseointegration in a rat implantation model. Anat Rec (Hoboken) 2009;292:38-47. https://doi.org/10.1002/ar.20748
  32. Friedrich RE, Todorovic M, Krull A. Simulation of scattering effects of irradiation on surroundings using the example of titanium dental implants: a Monte Carlo approach. Anticancer Res 2010;30:1727-30.
  33. Schoen PJ, Raghoebar GM, van Oort RP, Reintsema H, van der Laan BF, Burlage FR, Roodenburg JL, Vissink A. Treatment outcome of bone-anchored craniofacial prostheses after tumor surgery. Cancer 2001;92:3045-50. https://doi.org/10.1002/1097-0142(20011215)92:12<3045::AID-CNCR10147>3.0.CO;2-K
  34. Friedrich RE, Todorovic M, Heiland M, Scheuer HA, Krull A. Scattering effects of irradiation on surroundings calculated for a small dental implant. Anticancer Res 2012;32:2043-6.
  35. Wang R, Pillai K, Jones PK. Dosimetric measurement of scattered radiation from dental implants in simulated head and neck radiotherapy. Int J Oral Maxillofac Implants 1998;13:197-203.
  36. Stoll P, Wächter R, Hodapp N, Schilli W. Radiation and osteosynthesis. Dosimetry on an irradiation phantom. J Craniomaxillofac Surg 1990;18:361-6. https://doi.org/10.1016/S1010-5182(05)80057-5
  37. Pekmezci M, Dirican B, Yapici B, Yazici M, Alanay A, Gurdalli S. Spinal implants and radiation therapy: the effect of various configurations of titanium implant systems in a single-level vertebral metastasis model. J Bone Joint Surg Am 2006;88:1093-100.
  38. Granstrom G, Jacobsson M, Tjellstrom A. Titanium implants in irradiated tissue: benefits from hyperbaric oxygen. Int J Oral Maxillofac Implants 1992;7:15-25.

Cited by

  1. Synergistic effect of hyperbaric oxygen therapy with PTH [1-34] on calvarial bone graft in irradiated rat pp.1354523X, 2019, https://doi.org/10.1111/odi.13037
  2. Bone Regeneration Effect of Hyperbaric Oxygen Therapy Duration on Calvarial Defects in Irradiated Rats vol.2019, pp.None, 2016, https://doi.org/10.1155/2019/9051713
  3. Systemic and local effects of radiotherapy: an experimental study on implants placed in rats vol.24, pp.2, 2020, https://doi.org/10.1007/s00784-019-02946-5