Implantoprotetska terapija u rehabilitaciji onkoloških pacijenata nakon resektivnih postupaka u području glave i vrata

master's thesis

• Title (english): Implant prosthodontics therapy in the rehabilitation of oncology patients after resective procedures in the head and neck area
• Author: Iva Šarić
• Mentor: Ivica Pelivan (mentor)
• Committee member: Ivica Pelivan (predsjednik povjerenstva)
• Committee member: Vlaho Brailo (član povjerenstva)
• Committee member: Ivan Zajc (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2024-09-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Karcinomi glave i vrata koji su sedmi najčešći karcinomi u svijetu, često su asimptomatski u ranom stadiju, što dovodi do kasnog otkrivanja i liječenja. U slučajevima uznapredovalog karcinoma, radikalni kirurški zahvati i kemoradioterapija mogu značajno utjecati na funkcije gutanja, govora i estetiku lica. U ovom prikazu slučaja, pacijent je imao karcinom orofarinksa klasificiran kao T3N0M0. Nakon primarne bolesti i radikalnih kirurških zahvata, uključujući commando operaciju i rekonstrukciju pomoću anterolateralnog natkoljeničnog režnja, pacijent je prošao kompleksnu implantoprotetsku terapiju. Prije radioterapije, zubi u donjoj čeljusti su esktrahirani zbog nepovoljnih prognoza, dok je jedan molar u gornjoj čeljusti očuvan za buduću retenciju protetskih nadomjestaka. CBCT snimka pokazala je dovoljno kosti za ugradnju implantata u donju čeljust, što je omogućilo postavljanje tri Zimmer Biomet Trabecular Metal implantata. U gornjoj čeljusti, zbog prisutnosti molara, napravljena je subtotalna proteza. Nakon uspješne oseointegracije implantata i postave gingiva formera, započela je protetska faza koja je uključivala izradu i postavi novih proteza. Ove proteze značajno su poboljšale kvalitetu života sve do recidiva osnovne bolesti četiri i pol godine kasnije. Ovaj slučaj naglašava važnost multidisciplinarnog pristupa i integracije kirurških i protetskih metoda u rehabilitaciji pacijenata nakon radikalnih onkoloških zahvata te potrebu za prilagodbom terapije.

Abstract (english)

Head and neck cancers, which are the seventh most common cancers globally, are often asymptomatic in their early stages, leading to late detection and treatment. In cases of advanced cancer, radical surgical procedures and chemoradiotherapy can significantly affect swallowing, speech functions and facial aesthetics. In this case report, the patient was diagnosed with oropharyngeal carcinoma classified as T3N0M0. Following the primary disease and radical surgical procedures, including a commando operation and reconstruction using an anterolateral thigh (ALT) flap, the patient underwent complex implant – prosthetic therapy. Before radiotherapy, teeth in the lower jaw were extracted due to poor prognosis, while a molar in the upper jaw was preserved for future prosthetic retention. A CBCT scan revealed sufficient bone for implant placement in the lower jaw, allowing the insertion of three Zimmer Biomet Trabecular Metal implants. In the upper jaw, due to the presence of the molar, a subtotal denture was made. Following successful osseointegration of the implants and placement of gingiva formers, the prosthetic phase commenced, which included the creation and fitting of new dentures. These dentures significantly improved patient’s quality of life until the recurrence of the primary disease four and a half years later. This case highlights the importance of a multidisciplinary approach and the integration of surgical and prosthetic methods in rehabilitating patients after radical oncological procedures, as well as the need for therapy adjustment.

• Keywords: tumori glave i vrata; zubni implantati; pokrovna proteza; prečke
• Keywords (english): head and neck neoplasms; dental implants; overdenture; bar
• Language: croatian
• URN:NBN: urn:nbn:hr:127:621300
• Study programme: Title: Integrated undergraduate and graduate university study of Dental Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-09-13 11:10:02