RESUMO
PURPOSE: The aim of this study was to evaluate the success and survival rates of extraoral implants for the fixation of facial prostheses in three anatomical regions. MATERIALS AND METHODS: Subjects were consecutive patients with facial defects who underwent implant placement by the same surgeon in the orbital, nasal, and auricular regions between 2003 and 2012. After a minimum of 4 months of osseointegration, prostheses were anchored to the implants, and the patients were monitored for 11 to 111 months. Success rate, implant survival time, and occurrence of previous radiotherapy were evaluated. Rate of implant survival was estimated as a function of the anatomical region of the three groups (orbital, nasal, or auricular), and confidence intervals were calculated using Kaplan-Meier analysis with α = .05. RESULTS: In the 68 patients' 138 fixed implants, 48 showed defects in the orbital, 9 in the nasal, and 11 in the auricular region. The success rates and survival times were 95.9% and 8.6 years for the orbital, 92.9% and 2.8 years for the nasal, and 92% and 9.0 years for the auricular region, respectively. The success rate of implants in previously irradiated regions was 90.3% for the orbital and 100% for the auricular region. None of the patients was irradiated in the nasal region. CONCLUSION: No significant differences in implant success or survival were observed with regard to anatomical region or previous irradiation.
RESUMO
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is an adverse effect of drugs used to treat bone metabolism diseases, such as osteoporosis and bone metastases. The present study retrospectively evaluated the clinical characteristics and evolution of BRONJ cases that were diagnosed and treated at a dental school from 2004 to 2011. During that period, 13 patients met the criteria of the study among a population of 2,342 patients with oral lesions. Of the 13 patients, 12 were females. Ten were intravenous bisphosphonate users, and nine had breast cancer as the primary disease. Eight mandibular cases were observed. Eight patients interrupted the use of the bisphosphonates temporarily during the treatment. Surgical treatment was conducted in 10 patients, which was associated with platelet-rich plasma in six cases, which led to a regression to Stage I in 50% of these and cure in 33.3%. Of the total sample, four (30.8%) cases were cured, six (46.1%) regressed to Stage I, and three (23.1%) remained in Stage II after treatment. Dental rehabilitation occurred in seven patients. Dissemination of knowledge among professionals is essential for prevention and early diagnosis of BRONJ. Dental schools must act as reference centers and participate in the multidisciplinary care of bisphosphonate users.
