Osseointegrated craniofacial implants in the rehabilitation of orbital defects: An update of a retrospective experience in the United States

Joseph A. Toljanic, Steven E. Eckert, Eleni Roumanas, John Beumer, Joseph M. Huryn, Ian M. Zlotolow, David J. Reisberg, Susan W. Habakuk, Robert F. Wright, Jeffrey E. Rubenstein, Thomas R. Schneid, Paul Mullasseril, Lily T. Garcia, Jean Francois Bedard, Yong Geun Choi

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Statement of problem. Since their introduction, craniofacial implants have been used in prosthetic rehabilitation of facial defects. The literature, however, indicates marked variability in outcomes using implants for the retention of orbital prostheses. Purpose. A multicenter report updating the experience in the United States with the use of craniofacial implants for prosthetic rehabilitation of orbital defects is presented. Material and methods. Surveys were sent to clinicians at 25 centers where maxillofacial prosthetic treatment is provided to obtain retrospective data regarding patients who completed implant-retained orbital prosthetic rehabilitation. Data on implant placement location, radiation treatment history, and use of hyperbaric oxygen therapy were collected and assessed in relationship to implant survival over time. The Kaplan-Meier life table and Wilcoxon analyses (α=.05) were used to assess the significance of the findings. Results. Ten centers responded, providing data suitable for statistical analysis on 153 implants placed to retain 44 orbital prostheses and followed for a mean period of 52.6 months. Forty-one implant integration failures occurred during this follow-up period, resulting in an overall integration survival rate of 73.2%. No significant relationship was found between radiation treatment history, hyperbaric oxygen therapy history, or implant placement location and implant survival. Individual responses revealed large variability between reporting centers in treatment outcomes. Conclusion. Craniofacial implants may offer marked benefits in the prosthetic rehabilitation of orbital defects when compared to conventional adhesive retention designs. However, questions remain regarding long-term predictability and the impact specific factors may have on treatment outcomes. Insufficient data is currently available from which to draw statistically meaningful conclusions. The establishment of a national database designed to acquire adequate data to assess treatment outcomes is recommended.

Original languageEnglish (US)
Pages (from-to)177-182
Number of pages6
JournalJournal of Prosthetic Dentistry
Volume94
Issue number2
DOIs
StatePublished - Aug 2005
Externally publishedYes

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Rehabilitation
Orbital Implants
Hyperbaric Oxygenation
History
Prosthesis Retention
Radiation
Statistical Data Interpretation
Life Tables
Survival
Adhesives
Prostheses and Implants
Therapeutics
Survival Rate
Databases

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Osseointegrated craniofacial implants in the rehabilitation of orbital defects : An update of a retrospective experience in the United States. / Toljanic, Joseph A.; Eckert, Steven E.; Roumanas, Eleni; Beumer, John; Huryn, Joseph M.; Zlotolow, Ian M.; Reisberg, David J.; Habakuk, Susan W.; Wright, Robert F.; Rubenstein, Jeffrey E.; Schneid, Thomas R.; Mullasseril, Paul; Garcia, Lily T.; Bedard, Jean Francois; Choi, Yong Geun.

In: Journal of Prosthetic Dentistry, Vol. 94, No. 2, 08.2005, p. 177-182.

Research output: Contribution to journalArticle

Toljanic, JA, Eckert, SE, Roumanas, E, Beumer, J, Huryn, JM, Zlotolow, IM, Reisberg, DJ, Habakuk, SW, Wright, RF, Rubenstein, JE, Schneid, TR, Mullasseril, P, Garcia, LT, Bedard, JF & Choi, YG 2005, 'Osseointegrated craniofacial implants in the rehabilitation of orbital defects: An update of a retrospective experience in the United States', Journal of Prosthetic Dentistry, vol. 94, no. 2, pp. 177-182. https://doi.org/10.1016/j.prosdent.2005.04.016
Toljanic, Joseph A. ; Eckert, Steven E. ; Roumanas, Eleni ; Beumer, John ; Huryn, Joseph M. ; Zlotolow, Ian M. ; Reisberg, David J. ; Habakuk, Susan W. ; Wright, Robert F. ; Rubenstein, Jeffrey E. ; Schneid, Thomas R. ; Mullasseril, Paul ; Garcia, Lily T. ; Bedard, Jean Francois ; Choi, Yong Geun. / Osseointegrated craniofacial implants in the rehabilitation of orbital defects : An update of a retrospective experience in the United States. In: Journal of Prosthetic Dentistry. 2005 ; Vol. 94, No. 2. pp. 177-182.
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abstract = "Statement of problem. Since their introduction, craniofacial implants have been used in prosthetic rehabilitation of facial defects. The literature, however, indicates marked variability in outcomes using implants for the retention of orbital prostheses. Purpose. A multicenter report updating the experience in the United States with the use of craniofacial implants for prosthetic rehabilitation of orbital defects is presented. Material and methods. Surveys were sent to clinicians at 25 centers where maxillofacial prosthetic treatment is provided to obtain retrospective data regarding patients who completed implant-retained orbital prosthetic rehabilitation. Data on implant placement location, radiation treatment history, and use of hyperbaric oxygen therapy were collected and assessed in relationship to implant survival over time. The Kaplan-Meier life table and Wilcoxon analyses (α=.05) were used to assess the significance of the findings. Results. Ten centers responded, providing data suitable for statistical analysis on 153 implants placed to retain 44 orbital prostheses and followed for a mean period of 52.6 months. Forty-one implant integration failures occurred during this follow-up period, resulting in an overall integration survival rate of 73.2{\%}. No significant relationship was found between radiation treatment history, hyperbaric oxygen therapy history, or implant placement location and implant survival. Individual responses revealed large variability between reporting centers in treatment outcomes. Conclusion. Craniofacial implants may offer marked benefits in the prosthetic rehabilitation of orbital defects when compared to conventional adhesive retention designs. However, questions remain regarding long-term predictability and the impact specific factors may have on treatment outcomes. Insufficient data is currently available from which to draw statistically meaningful conclusions. The establishment of a national database designed to acquire adequate data to assess treatment outcomes is recommended.",
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T2 - An update of a retrospective experience in the United States

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AU - Eckert, Steven E.

AU - Roumanas, Eleni

AU - Beumer, John

AU - Huryn, Joseph M.

AU - Zlotolow, Ian M.

AU - Reisberg, David J.

AU - Habakuk, Susan W.

AU - Wright, Robert F.

AU - Rubenstein, Jeffrey E.

AU - Schneid, Thomas R.

AU - Mullasseril, Paul

AU - Garcia, Lily T.

AU - Bedard, Jean Francois

AU - Choi, Yong Geun

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N2 - Statement of problem. Since their introduction, craniofacial implants have been used in prosthetic rehabilitation of facial defects. The literature, however, indicates marked variability in outcomes using implants for the retention of orbital prostheses. Purpose. A multicenter report updating the experience in the United States with the use of craniofacial implants for prosthetic rehabilitation of orbital defects is presented. Material and methods. Surveys were sent to clinicians at 25 centers where maxillofacial prosthetic treatment is provided to obtain retrospective data regarding patients who completed implant-retained orbital prosthetic rehabilitation. Data on implant placement location, radiation treatment history, and use of hyperbaric oxygen therapy were collected and assessed in relationship to implant survival over time. The Kaplan-Meier life table and Wilcoxon analyses (α=.05) were used to assess the significance of the findings. Results. Ten centers responded, providing data suitable for statistical analysis on 153 implants placed to retain 44 orbital prostheses and followed for a mean period of 52.6 months. Forty-one implant integration failures occurred during this follow-up period, resulting in an overall integration survival rate of 73.2%. No significant relationship was found between radiation treatment history, hyperbaric oxygen therapy history, or implant placement location and implant survival. Individual responses revealed large variability between reporting centers in treatment outcomes. Conclusion. Craniofacial implants may offer marked benefits in the prosthetic rehabilitation of orbital defects when compared to conventional adhesive retention designs. However, questions remain regarding long-term predictability and the impact specific factors may have on treatment outcomes. Insufficient data is currently available from which to draw statistically meaningful conclusions. The establishment of a national database designed to acquire adequate data to assess treatment outcomes is recommended.

AB - Statement of problem. Since their introduction, craniofacial implants have been used in prosthetic rehabilitation of facial defects. The literature, however, indicates marked variability in outcomes using implants for the retention of orbital prostheses. Purpose. A multicenter report updating the experience in the United States with the use of craniofacial implants for prosthetic rehabilitation of orbital defects is presented. Material and methods. Surveys were sent to clinicians at 25 centers where maxillofacial prosthetic treatment is provided to obtain retrospective data regarding patients who completed implant-retained orbital prosthetic rehabilitation. Data on implant placement location, radiation treatment history, and use of hyperbaric oxygen therapy were collected and assessed in relationship to implant survival over time. The Kaplan-Meier life table and Wilcoxon analyses (α=.05) were used to assess the significance of the findings. Results. Ten centers responded, providing data suitable for statistical analysis on 153 implants placed to retain 44 orbital prostheses and followed for a mean period of 52.6 months. Forty-one implant integration failures occurred during this follow-up period, resulting in an overall integration survival rate of 73.2%. No significant relationship was found between radiation treatment history, hyperbaric oxygen therapy history, or implant placement location and implant survival. Individual responses revealed large variability between reporting centers in treatment outcomes. Conclusion. Craniofacial implants may offer marked benefits in the prosthetic rehabilitation of orbital defects when compared to conventional adhesive retention designs. However, questions remain regarding long-term predictability and the impact specific factors may have on treatment outcomes. Insufficient data is currently available from which to draw statistically meaningful conclusions. The establishment of a national database designed to acquire adequate data to assess treatment outcomes is recommended.

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