Head and Neck Cancer, Osteonecrosis, Osteoradionecrosis
Conditions
Keywords
bisphosphonates, jaw reconstruction, prosthetic rehabilitation, quality of life, monoclonal antibodies' targeted therapy
Brief summary
The investigators aim to develop a prospective database in which patient demographics, surgical, dental, prosthetic and QOL parameters collected during consecutive visits within the framework of routine practice, are being registered for each oncological patient eligible for (immediate/delayed) fixed prosthodontic rehabilitation at time of oral cavity reconstruction
Detailed description
The number of patients requiring major ablative surgery in the oral cavity, including partial/radical mandibular or maxillary resection, due to a head and neck carcinoma, osteoradionecrosis (ORN), or medication-related osteonecrosis of the jaw (MRONJ) has not been accurately reported. Surgical reconstruction to restore oral function and aesthetics forms a challenge to maxillofacial surgeons, and greatly impacts patient' quality of life (QOL). Recently, an active collaboration between the surgeons of the Oral and Maxillofacial Surgery Unit and the prosthodontist (LB) of the Department of Dentistry at the General Hospital Saint-John Bruges led to the development of the Oncology-bridge (O-bridge) protocol, which offers (immediate/delayed) fixed prosthetic rehabilitation in a minimum of sessions and a strongly reduced two-week treatment time, consequently accelerating patient' improved QOL at a considerably reduced cost. The investigators aim to develop a prospective database in which patient demographics, surgical, dental, prosthetic and QOL parameters collected during consecutive visits within the framework of routine practice, are being registered for each oncological patient eligible for (immediate/delayed) fixed prosthodontic rehabilitation at time of oral cavity reconstruction This could provide the investigators with more information about potential patient, surgical and prosthetic factors influencing short- and long-term biological and mechanical stability, as well as patient QOL. Moreover, registration of those results could function as a measurement of quality of care, and could be used for sample size calculation for future large prospective trials.
Interventions
None listed
Sponsors
AZ Sint-Jan AV
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients of all ages * Patients of all genders * Patients with a histologically or clinically confirmed diagnosis of ORN, MRONJ, as classified by Ruggiero et al. (Ruggiero, et al., 2014) or carcinoma located in the oral cavity and jawbone, requiring segmental or total jaw resection * Patients eligible for jaw and oral cavity reconstruction combined with immediate/delayed implant loading for fixed prosthetic rehabilitation * Patients not eligible for conventional removable prosthetic rehabilitation
Exclusion criteria
* Patients with a clinically confirmed diagnosis of osteonecrosis not related to an oncological diagnosis or treatment * Patients with medical contraindications for jaw reconstruction combined with immediate implant loading for fixed prosthetic rehabilitation * Patients eligible for conventional removable prosthetic rehabilitation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| prosthesis survival rate | within 12 months postoperative |
| implant survival rate | within 12 months postoperative |
| bone resorption, as evaluated with cone-beam computed tomography | within 12 months postoperative |
Secondary
| Measure | Time frame |
|---|---|
| Patient' quality of life after prosthetic rehabilitation | until a maximum of 60 months follow-up |
| Prevalence of oncological patients requiring jaw reconstruction secondary to tumour resection, ORN or MRONJ | within 12 months postoperative |
| Potential biologic or mechanical risk factors predictive of undesirable functional or aesthetic outcomes, through regression analysis | within 60 months postoperative |
Other
| Measure | Time frame |
|---|---|
| patient satisfaction, as measured through visual analogue scale | until a maximum of 60 months follow-up |
Countries
Belgium
Contacts
Primary ContactAraceli Diez-Fraile, PhD
Outcome results
None listed