头颈癌患者种植体的全面更新（2021-2024）：放疗和化疗对种植体生存影响的系统回顾和Meta分析

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research Pub Date : 2025-06-18 DOI:10.1111/clr.14450

Shengchi Fan, Leonardo Diaz, Gustavo Sáenz‐Ravello, Eduard Valmaseda‐Castellon, Bilal Al‐Nawas, Eik Schiegnitz

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引用次数: 0

摘要

目的结合最新研究成果，探讨头颈癌放疗或化疗患者种植体的预后。方法本综述旨在更新焦点问题：与未放疗的患者相比，头颈癌放疗或化疗患者植入植入物的生存率如何？它建立在之前的两次系统综述（2014年和2022年）的基础上，并提供了最新的文献综合，重点关注2021年至2024年发表的临床研究。早期的评论被纳入定量综合只是为了提供更广泛的纵向观点。结果共纳入9项研究，其中7项纳入了定量综合和荟萃分析。放疗组种植体存活率（85.6%）明显低于未放疗组（90.0%）(RR = 1.62, 95% CI: 1.33-1.98, p <；0.0001, i2 = 0.2%)。此外，移植骨的种植体失败风险高于原生骨（RR = 2.03, 95% CI: 1.39-2.96, p = 0.0018, I2 = 21.9%）。在接受放疗的患者中，与未接受放疗的患者相比，接受放化疗的患者表现出更大的种植失败风险（RR = 1.97, 95% CI: 1.09-3.56, p = 0.0331, I2 = 0%）。结论：目前的证据表明，放疗/化疗显著增加头颈癌患者种植体丢失的风险，较高的辐射剂量可能与种植体周围骨质丢失增加有关，而种植体放置在天然骨中的失败风险较放置在移植物骨中的低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Comprehensive Update on Implants in Patients With Head and Neck Cancer (2021–2024): Systematic Review and Meta‐Analysis of the Impact of Radiotherapy and Chemotherapy on Implant Survival

ObjectivesThis study aimed to investigate implant outcomes in patients with head and neck cancer undergoing radiotherapy or chemotherapy by incorporating the latest research findings.MethodsThe present review was conducted to update the focused question: What is the survival rate of implants placed in patients with head and neck cancer receiving radiotherapy or chemotherapy compared to non‐irradiated patients? It built upon two previous systematic reviews (2014 and 2022) and provided an updated synthesis of the literature, focusing on clinical studies published between 2021 and 2024. The earlier reviews were included in the quantitative synthesis only to offer a broader longitudinal perspective.ResultsNine studies were identified, with seven included in the quantitative synthesis and meta‐analysis. The implant survival rate was significantly lower in irradiated patients (85.6%) compared to non‐irradiated patients (90.0%) (RR = 1.62, 95% CI: 1.33–1.98, p < 0.0001, I2 = 0.2%). Additionally, implant failure risk was higher in grafted bone (RR = 2.03, 95% CI: 1.39–2.96, p = 0.0018, I2 = 21.9%) than in native bone. Among irradiated patients, those receiving radiochemotherapy exhibited an even greater risk of implant failure (RR = 1.97, 95% CI: 1.09–3.56, p = 0.0331, I2 = 0%) compared to non‐irradiated patients.ConclusionsCurrent evidence indicates that radiotherapy/chemotherapy significantly increases the risk of implant loss in patients with head and neck cancer, with higher radiation doses possibly being associated with increased peri‐implant bone loss, while implants placed in native bone exhibit a lower risk of failure compared to those placed in grafted bone.

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来源期刊

Clinical Oral Implants Research 医学-工程：生物医学

CiteScore

7.70

自引率

11.60%

发文量

149

审稿时长

3 months

期刊介绍： Clinical Oral Implants Research conveys scientific progress in the field of implant dentistry and its related areas to clinicians, teachers and researchers concerned with the application of this information for the benefit of patients in need of oral implants. The journal addresses itself to clinicians, general practitioners, periodontists, oral and maxillofacial surgeons and prosthodontists, as well as to teachers, academicians and scholars involved in the education of professionals and in the scientific promotion of the field of implant dentistry.