NUMERO: #20250544

Título: Challenges in dental rehabilitation in oral cancer patients: management of osteoradionecrosis post-implant placement

Nome do Apresentador: André GUOLLO

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Cirurgia e traumatologia bucomaxilofacial

Resumo: A 60-year-old male patient was diagnosed with floor of mouth squamous cell carcinoma (pT2 pN2c) in September 2016. He underwent pelvectomy combined with bilateral radical neck dissection, alongside three cycles of chemotherapy (cisplatin) and 33 sessions of radiotherapy (6600 cGy) in March 2017. In 2020, four HE implants (Nobelbiocare Mk III) were placed for the fabrication of a protocol-type prosthesis, with the definitive prosthesis installed in October 2021. One year after prosthesis loading, the onset of peri-implant osteolysis was observed. Local measures were instituted (hygiene and 0.12% chlorhexidine). However, there was progressive bone loss around the implants, involving the basal region, suggestive of osteoradionecrosis (ORN). The first surgical approach involved the removal of two distal implants, bone debridement, and osteosynthesis. Disease control was not achieved, leading to two segmental resection procedures for margin expansion without reconstruction. After radical treatment, ORN control was achieved. The patient is currently under outpatient follow-up.

Autor 1:  Gustavo Luiz Alkmin PAIVA

E-mail 1:  [email protected]

Autor 2:   Bruno Felipe GAIA

E-mail 2:  [email protected]

Autor 3 :  Rodrigo Nascimento LOPES

E-mail 3:  [email protected]

Autor 4:  André GUOLLO

E-mail 4:  [email protected]

Autor 5:  André Caroli ROCHA

E-mail 5:  [email protected]

Autor 6:  Thaís Bianca BRANDÃO

E-mail 6:  [email protected]