• 111 pxs oncológicos

• 706 implantes
• Sobre microvascularizados
• 92.9 % éxito oseointegración
• 15 % falla
• En cirugía oncológica la rehabilitación dental representa un reto por el bajo
rango de éxito, generalmente en pxs radiados

• Riediger y Urken pioneros en implantología sobre microvascularizados

• INMEDIATOS

• ASPECTOS CONTROVERSIALES
such as radiotherapy, the reconstructive method used, the type of bone flap
used, the optimum timing of implant placement, and the dental rehabilitation
provided.
• 252 in the grafted bone
• 454 in the remnant bone.
• 12 CASOS EN MAXILAR
• 66 CASOS MICROVASCULAR
• FIBULA 29 cases (Figs 1-6),
• CRESTA ILIACA 25 (Figs 7-12),
• RADIAL 8
• ESCAPULAR 3
• RESTO ABDOMINAL 1
• TRAPEZIO 16
• PECTORAL 8
• TEMPORAL 7
• BUCCAL 2
• TEMPOROPARIETAL 1
• COLGAJOS LOCALES
• Radioterapia 79 pxs (395 implantes)
In 45 cases (56.9%) the implants were placed before irradiation,
whereas in the remaining 34 (43.1%) they were placed at a minimum of
12 months after the conclusion of radiotherapy.

None of our patients received treatment with hyperbaric oxygen.

RESULTADOS
• De 706, 29 falla oseointegración 4.1 %
• 31 implantes no rehabilitables
• Después de la prótesis 52 falla…8%
DISCUSIÓN
• PERDIDA DE PROPIOCEPCION
• SOBREDENTADURAS
• RANGOS DE SUPERVIVENCIA DEL 56 AL 98%
• OXIGENO HIPERBARICO
PROTOCOLO
• IMPLANTES EN 12 MESES
• NO PROVISIONALES

• In patients with oral oncologic problems subjected to adjuvant radiotherapy, implant-

supported prostheses are the only useful form of dental rehabilitation. 2. Prosthetic
dental rehabilitation in such patients poses numerous technical difficulties because of
the anatomic and functional alterations produced after surgery. 3. Percentage
osseointegration in these patients is almost analogous to that recorded in the
nonsurgical population. 4. Mandibular reconstruction without dental rehabilitation only
contributes to improve facial esthetics. 5. Implants exposed to maximum radiation
doses present the highest complication rates. 6. Implants in OMCT flaps present
significantly greater failure rates than when iliac crest and fibular flaps are used.