Biomedical subjects

J M Kwakman

Publications and source records attributed to J M Kwakman.

7 recordsLinked to original sources

PubMed2000

[Needs for implant therapy in cancer patients; a retrospective study].

After cancer treatment in the head and neck area, mastication and speech are often affected. Some of the problems encountered can be solved by adequate dental rehabilitation. However, dental rehabilitation is often compromised, for various reasons. The change in anatomy due to surgery often results in lack of denture bearing mucosa. The effects of radiotherapy of the salivary glands and the mucosa result in dry oral tissues and diminished retention of removable dentures. Osseointegrated implants can help to solve these problems. Implant treatment has, so far, not been widely used in cancer patients. An analysis was made of 95 consecutive patients with a tumor in the head and neck area. The indication for treatment with osseointegrated implants was reviewed and the need for implants as experienced bij patients was evaluated. Results show that 45% did not need specific prosthetic rehabilitation, and approximately 25% of the patients could benefit from osseointegrated implants. Due to general and local contra-indications and patients' refusal, only 3% actually have been treated. For complete oral rehabilitation of this group of patients the use of osseointegrated implants should be considered at an early stage, before the initial tumor treatment.

Adult↗

PubMed1998

Treatment of the edentulous mandible with a vestibuloplasty combined with Intramobil Zylinder implants: a 5-year follow-up.

The long-term success of endosseous implants is related to healthy peri-implant tissues. Attached keratinized mucosa does not seem important for the prevention of soft tissue complications. Prevention of muscle attachment near the implants, however, seems more decisive for maintaining a favourable peri-implant environment. We treated 150 patients from 1990-91 with two Intramobil Zylinder implants and modified vestibuloplasty, 65 of whom were randomly selected for evaluation at 1 year; 48 of the 65 were also seen at 5 years. The vestibuloplasty was done by the technique of Pichler and Trauner, to prevent muscle pull and to create a thin layer of mucosa around the implants, and endosseous osseointegrated implants were inserted. The results show an adequately depended vestibulum with no muscle pull around the implants and significantly lower pocket depth after 5 years of follow-up compared with similar studies.

Chi-Square Distribution↗

PubMed1998

Randomized prospective clinical trial of two implant systems for overdenture treatment: a comparison of the 2-year and 5-year results using the clinical implant performance scale.

In a prospective randomized clinical trial, edentulous patients were treated with dental implants and overdentures. The results of treatment with two IMZ implants connected by a Dolderbar, and a transmandibular implant (TMI) were compared. By using the clinical implant performance scale, the clinical and radiographic data were evaluated and compared after a two-year and five-year follow up. After the five-year follow up, significantly less problems and complications were recorded in the IMZ group than in the TMI group (Wilcoxon, P=0.03). When compared to the two-year follow up, there was, however, a gradual increase of scores on the clinical implant performance scale in the IMZ group, while in the TMI group only a slight increase was recorded.

Adult↗

PubMed1997

Bone level changes in patients with transmandibular implants.

PURPOSE: In this article, the mandibular bone height in edentulous patients previously treated with a transmandibular implant was evaluated after the dentures were modified according to the latest prosthetic protocol. PATIENTS AND METHODS: The bone height of 36 patients was measured on three radiographs; the first at the time of insertion of the implant, the second just before using the latest prosthetic protocol, and the third 1 year later. RESULTS: A slight bone increase at the lateral posts and at the cortical screws mesial to these posts was measured. No significant bone increase was found above the lateral cortical screw. CONCLUSION: The bone increase that is found in this study was not of the extent indicated in earlier reports.

Adult↗

PubMed1997

Improvement in oral function following tumour surgery by a combination of tongue plasty by the Steinhäuser technique and osseointegrated implants.

Oral functions such as speaking, chewing and swallowing are often reduced after ablative tumour surgery in the mouth and oropharynx. For restoration of at least a part of these functions, stable dentures and satisfactory mobility of the tongue are necessary. Dental implants can be used to achieve stable dentures. Pre-implant surgery, however, is often needed to reduce the amount of bulky tissue when myocutaneous flaps have been used for reconstruction, and to achieve adequate mobility of the tongue. A combination of tongueplasty by the Steinhäuser technique and osseointegrated implants will be described and discussed. Twelve patients have been treated by this technique between 1992 and 1995, with a mean follow up of 11.6 months. All patients reported an improved tongue mobility and ability to chew. Tongueplasty by the Steinhäuser technique with secondary epithelialization, in combination with osseointegrated implants, is a simple and effective means of improving oral function.

Deglutition↗

PubMed1997

Osseointegrated oral implants in head and neck cancer patients.

After cancer treatment in the head and neck area, mastication and speech are often affected. Some of the problems encountered can be solved by adequate dental rehabilitation. However, dental rehabilitation is often compromised for various reasons. The change in anatomy due to surgery often results in lack of denture-bearing mucosa. The effects of radiotherapy on the salivary glands and the mucosa result in dry oral tissue and diminished retention of removable dentures. Osseointegrated oral implants can help to solve these problems. Although implant treatment for patients with cancer of the head and neck is covered by the Dutch national health insurance, and there is therefore no financial obstacle, implants have not, so far, been widely used with these patients. In order to establish the possible reasons for this, an analysis was performed. Retrospective data on 95 consecutive patients were collected from records. The indication for the use of oral osseointegrated implants was reviewed. Analysis of the data showed that 45% did not need specific prosthetic rehabilitation. An indication for the use of osseointegrated implants was found in 25% of the patients. For various reasons, only 3% actually received implants. In striving to completely rehabilitate a cancer patient, the possible use of osseointegrated oral implants should be evaluated before the initial oncological treatment begins. The insertion of implants during the initial surgical procedure should be considered more often, with a view to reducing the number of surgical procedures.

Adult↗

PubMed1996

Transmandibular implant versus intramobile cylinder implants: a randomized, prospective clinical trial.

A randomized, controlled clinical trial was conducted to compare two different implant treatment modalities for edentulous patients with severely resorbed mandibles. In one modality (the IMZ group), two intramobile cylinder implants were placed, connected by a Dolder bar and provided with an overdenture, and in the other (the TMI group), a transmandibular implant with a triple bar and cantilever extensions was placed, likewise provided with an overdenture. The conditions of the overdentures, the peri-implant tissues, and the implants were evaluated. Orthopantomograms were taken for radiologic evaluation. An overall complication scale which took account of all aspects was devised to compare the results. The follow-up period was 2-4 years, with a mean follow-up of 3 years. The condition of dentures and oral hygiene aspects were comparable for both groups. The complication rate in the TMI group was significantly higher than that in the IMZ group. The scores on the complication scale resulted in a significant difference between the TMI and the IMZ groups (Wilcoxon, P = 0.0044).

Alveolar Bone Loss↗