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Outcome of healing after dental implant placement in patients with cancer on high-dose antiresorptive medications: a prospective feasibility study

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Abstract

Purpose

Implant placement in patients with cancer receiving high-dose antiresorptive medication (HDAR) is considered contraindicated. This prospective, feasibility study tested the hypothesis that dental implants can be placed in such patients by applying a staged implant placement protocol with submerged healing.

Methods

Three groups of patients on HDAR were included as follows: group 1: patients who underwent tooth extraction, without the development of medication-related osteonecrosis of the jaws (MRONJ); group 2: patients with surgically treated MRONJ who had demonstrated clinical healing for at least 3 months; group 3: patients with established MRONJ who was planned for surgical resection and simultaneous implant placement.

Results

A total of 49 implants were placed in 27 patients (group 1: 12, group 2: 7 and group 3: 8). HDAR included bisphosphonates and denosumab. The mean HDAR time was 25 months (SD: ± 18.4, range 3–68 months). An abutment operation was performed 4 months following the implant placement (SD: ± 1.9, range 3–14 months). All patients healed uneventfully.

Conclusions

This study demonstrated that it is feasible to insert dental implants and perform an abutment surgery in patients with cancer on HDAR, without the development of MRONJ.

Trial registration.

ClinicalTrials.gov Identifier: NCT04741906.

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Acknowledgements

We thank Kasper Rasmus Kuniss Kriegbaum and Even Nisja for their surgical assistance. We also thank Ditte Mogensen for the proofreading and statistical analyses.

Funding

This work was supported by the committee KOF (Account for Dental Research) under the Danish Dental Association (grant no. 036, 2017); Amgen Limited, Cambridge, United Kingdom (grant no. 20167865, 2016); Institute Straumann AG, provided implants and abutments free of charge. Neither was involved in the study design, collection, analysis or interpretation of data, report writing or the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Sanne Werner Møller Andersen, Simon Storgård Jensen, Thomas Kofod & Morten Schiodt

  2. Department of Oral Rehabilitation, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 20, 2200, Copenhagen N, Denmark

    Camilla Ottesen & Klaus Gotfredsen

  3. Department of Oral Surgery, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 20, 2200, Copenhagen N, Denmark

    Simon Storgård Jensen

  4. Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200, Aarhus N, Denmark

    Morten Schiodt

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  1. Sanne Werner Møller Andersen
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  2. Camilla Ottesen
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  3. Klaus Gotfredsen
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Contributions

Sanne Werner Moeller Andersen: conceptualization, methodology, validation, formal analysis, investigation, data curation, writing original draft, writing review and editing, visualisation, supervision, project administration, founding acquisition

Morten Schiodt: principal investigator (PI) for the project, conceptualization, methodology, validation, formal analysis, investigation, resources, data curation, writing review and editing, visualisation, supervision, project administration, founding acquisition

Thomas Kofod: validation, investigation, resources, writing review and editing, supervision

Camilla Ottesen: validation, investigation, data curation, writing review and editing, visualisation

Klaus Godtfredsen: validation, investigation, resources, data curation, writing review and editing

Simon Storgaard Jensen: validation, writing review and editing, supervision

Corresponding author

Correspondence to Sanne Werner Møller Andersen.

Ethics declarations

Ethics approval

The study was approved by the appropriate ethics committee H-17025531 October 10, 2017, and data protection agency No. 2012–41-0045 January 11, 2012.

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All patients signed an informed consent.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Morten Schiodt Passed away before the submission.

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Andersen, S.W.M., Ottesen, C., Gotfredsen, K. et al. Outcome of healing after dental implant placement in patients with cancer on high-dose antiresorptive medications: a prospective feasibility study. Oral Maxillofac Surg 27, 89–100 (2023). https://doi.org/10.1007/s10006-022-01042-5

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