Guided placement of zygomatic implants in head and neck cancer patients: implant survival and patient outcomes at 1-3 years of follow-up

N Vosselman; J Kraeima; K Ng Wei Siang; G M Raghoebar; M J H Witjes; S A H J de Visscher

doi:10.1016/j.ijom.2024.03.001

Guided placement of zygomatic implants in head and neck cancer patients: implant survival and patient outcomes at 1-3 years of follow-up

Int J Oral Maxillofac Surg. 2024 Mar 16:S0901-5027(24)00057-2. doi: 10.1016/j.ijom.2024.03.001. Online ahead of print.

Authors

N Vosselman¹, J Kraeima², K Ng Wei Siang³, G M Raghoebar², M J H Witjes², S A H J de Visscher²

Affiliations

¹ Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: n.vosselman@umcg.nl.
² Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
³ Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands.

PMID: 38494409
DOI: 10.1016/j.ijom.2024.03.001

Abstract

Zygomatic implants (ZI) are a valuable option for supporting an obturator prosthesis after maxillary resection. This study was performed to assess the clinical outcomes of a digitally validated guided technique for ZI placement, followed by immediate prosthetic obturation. The primary objective was to evaluate implant survival, while the secondary objective was to assess patient-reported quality of life post-rehabilitation. Twelve patients treated for head and neck cancer received a total of 36 ZI after ablative surgery. The mean duration of ZI follow-up was 30.1 months. The survival rate of ZI placed in non-irradiated patients was 100%, while it was 85% in irradiated patients. Patient-reported outcomes were evaluated using the Liverpool Oral Rehabilitation Questionnaire (LORQv3) and the University of Washington Quality of Life Questionnaire (UW-QOL v4). Most patients reported satisfactory outcomes in the oral function domain of the LORQv3 (mean score 17.7 ± 4.5; possible range 12-48, with lower scores indicating better outcomes). Regarding the UW-QOL v4, the swallowing and chewing domains had the highest scores (mean 97.5 ± 8.7 and 95.8 ± 14.4, respectively; maximum possible score of 100). In conclusion, this treatment approach improves function and quality of life after maxillary ablative surgery. However, irradiated patients showed a noticeable trend of higher implant failure, and this was influenced by tumour position and size impacting the radiation dose to the zygomatic bone.

Keywords: Computer-assisted surgery; Dental implants; Dental prosthesis; Head and neck cancer; Maxilla; Zygoma.