Role of selected salivary inflammatory cytokines in the diagnosis and prognosis of oral squamous cell carcinoma. A Systematic Review and Meta-analysis

Background: Oral squamous cell carcinoma (OSCC) is gradually increasing its incidence in our society. Unfortunately, this entity is diagnosed at an advanced stage in most patients, a fact that implies greater difficulty in its treatment and a worse prognosis. This systematic review aims to assess whether the cytokines IL-6, IL-8 and TNF-α are potential salivary biomarkers that allow early diagnosis of cancer. Material and methods: An electronic search was performed in three databases (Pubmed, Scopus and Web of Science). We used the following keywords: "salivary cytokines", "saliva cytokines", "salivary interleukins", "biomarkers", "oral squamous cell carcinoma" and "diagnosis", combined with the Boolean operators "AND" and "OR". Results: 128 publications were found and finally 23 articles were included in the review and 15 in the meta-analysis. It has been observed that the majority of OSCC patients express higher salivary concentrations of IL-6, IL-8 and TNF-α compared to the control (CL) and premalignant lesion (OPML) groups. It has also been observed that the different premalignant lesions do not have statistically significant differences in the salivary concentration of the cytokines, and on the other hand, differences have been observed between the different TNM stages. The meta-analysis has shown that the difference in concentration of IL-6, IL-8 and TNF-α is statistically significant between the CL group and the OSCC, and also between the CL group and OPML. Conclusions: There is sufficient evidence to affirm that IL-6, IL-8 and TNF-α are useful salivary cytokines in the early diagnosis and prognosis of OSCC. Although future studies are necessary to establish greater reliability of these biomarkers and thus be able to develop a valid diagnostic test. (AU)

Association between the Mediterranean Diet and Vitamin C and the Risk of Head and Neck Cancer.

Diet may modulate the risk of head and neck cancer (HNC) through antioxidant and anti-inflammatory effects. To date, there is limited evidence regarding the effects of the Mediterranean diet on HNC risk. The purpose of the study was to assess the association between Mediterranean diet adherence, type of diet, and vitamin C and the risk of HNC. A case-control study was conducted at the Dentistry Hospital, University of Barcelona, including 101 cases of HNC and 101 controls matched by age and sex. Dietary habits were assessed using a 14-question Mediterranean diet score that classified the type of diet into healthy diet (10-14 points), regular diet (5-9 points), and unhealthy diet (≤4 points). Multivariate logistic regression models were used to assess the association between Mediterranean diet adherence, type of diet, and vitamin C and the risk of HNC. Higher adherence to the Mediterranean diet was significantly associated with a lower risk of HNC (OR = 0.88, 95% CI: 0.79-0.98). A healthy diet (OR = 0.29, 95% CI: 0.10-0.84) and vitamin C intake (OR = 0.25, 95% CI: 0.10-0.62) were strongly associated with lower odds of HNC. Moderate egg intake was the only type of food significantly associated with a lower risk of HNC. Dietary patterns that emphasize a high intake of antioxidant and anti-inflammatory bioactive components may have a protective effect on the risk of HNC.

Role of thyroid hormones in burning mouth syndrome. Systematic review

Background: Burning mouth syndrome is an idiopathic condition characterized by burning pain in a normal-appearing oral mucosa lasting at least four to six months. In the case of secondary burning mouth syndrome is associated with local or systemic factors (such as thyroid disorders) that can cause these symptoms. The aim of this review was to study the relationship between thyroid disorders and burning mouth syndrome.Material and methods: The present study followed the PRISMA guidelines. An electronic search strategy was developed for PubMed/Medline, Scopus and Cochrane. The following combination of keywords and Boolean operators were used: Thyroid AND burning mouth; Thyroid AND burning mouth syndrome; Hypothyroidism AND burning mouth; Hypothyroidism AND burning mouth syndrome; Hyperthyroidism AND burning mouth; Hyperthyroidism AND burning mouth syndrome. The results were processed by existing free software in https://www.graphpad.com/. To evaluate the association of the categorical variables we used the Fisher test at a level of significance of p-value ≤ 0,05. As a primary summary measure the Odds Ratio (OR) has been used. To analyze the risk of bias the guidelines of the GRADE guide were used and the grade of evidence was analyzed by the guide of Joanna Briggs Institute: Levels of Evidence and Grades of Recommendations.Results: After applying the inclusion and exclusion criteria, 5 studies were selected for review. The Chi-square was 10.92 and the Odds Ratio was 3.31 with respect to TSH values with p <0.0001 (Fisher's test). The population of patients with TSH alterations is increased in 80.49% and decreased in 19.51%.Conclusions: It can be concluded that thyroid hormone abnormalities are a factor in secondary burning mouth syndrome; specially in patients with hypothyroidism. (AU)

Patients with Thyroid Disorder, a Contraindication for Dental Implants? A Systematic Review.

The thyroid gland is composed of the thyroid follicles, considered to be the functional units of the thyroid gland. The synthesis of the thyroid hormones occurs in these follicles. Triiodothyronine (T3) and thyroxine (T4) are the thyroid hormones and affect metabolic processes all through the body. This systematic evaluation was performed to answer the following PICO question: "Can patients with thyroid disorders undergo dental implant rehabilitation with the same survival rate as patients without thyroid disorders?". A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to gather available and current evidence of thyroid disorders and its relationship with dental implants. The electronic search, in the PubMed and Cochrane databases, yielded 22 articles. Out of the 22 articles, only 11 fulfilled the inclusion criteria. Manual research of the reference list yielded no additional papers. According to the SORT criteria and answering our PICO question, level B can be established to conclude that patients with thyroid disorders can be rehabilitated with dental implants, with similar survival rates as patients without thyroid disorders. Papers with higher scientific evidence and bigger sample size should be carried out.

Effects of the Prior Use of Statins on Head and Neck Cancer Risk: A Hospital-Based Case-Control Study.

Mechanisms related to the potential beneficial effects of statins on cancer are mainly related to the inhibition of the mevalonate pathway. The purpose of this study was to assess the association between prior use of statins and the risk of head and neck cancer. A hospital-based case-control study was conducted at the Dentistry Hospital of the University of Barcelona, including 101 incident cases of head and neck cancer and 101 controls matched to cases by age and sex. Multivariate logistic regression models were used to assess the association between prior statin exposure and head and neck cancer risk. Of the 202 patients included in total, 28.2% had previously received prescriptions for statins. Prior use of statins was found in 25.7% of cases and 30.7% of controls. Exposure to statins was not associated with head and neck cancer risk (OR = 0.72; 95% CI 0.28-1.84; p = 0.49). There was also no time- or dose-dependent association. Similar trends were observed when analyzed by subsites of cancer and recurrence rate. Our findings do not support a beneficial effect of prior statin exposure on head and neck cancer risk. Future research relying on observational data should emulate randomized clinical trials before clinical implications for repurposing drugs can be drawn.

Periapical and endodontic status of patients with inflammatory bowel disease: Age- and sex-matched case-control study.

AIM: Crohn's disease (CD) and ulcerative colitis (UC) are two chronic recurrent inflammatory processes of the gastrointestinal tract, grouped under the name inflammatory bowel disease (IBD), causing clinical episodes of intestinal inflammation. The aim of this study was to investigate the possible association between IBD and the prevalence of apical periodontitis (AP) and root canal treatment. METHODOLOGY: A case-control study design matched to age and sex was used. The study group (SG) included 28 patients with IBD (13 with CD, 15 with UC). Another 28 healthy subjects, without IBD and age- and sex-matched, were included in the control group (CG). Radiographic records were analysed and AP was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score. Student's t-test, χ2 test and multivariate logistic regression were used in the statistical analysis. RESULTS: In the CG, only 17 subjects (61%) had at least one tooth with AP, whilst in the SG group they were 23 patients (82%; OR = 2.98; 95% CI = 0.87-10.87; p = .08). The number of subjects with one or more root filled teeth (RFT) in the CG was 14 (50%), whilst in the SG they were 22 (79%; OR = 3.67; 95% CI = 1.14-11.79; p = .026). At least one RFT with AP was evident in three subjects (10.7%) in the CG, whilst in the SG 15 patients (53.6%) showed RFT with AP (OR = 9.60; 95% CI = 2.35-39.35; p = .001). In the multivariate logistic regression analysis, only endodontic status was found to be associated with IBD (OR = 1.86; 95% CI = 1.24-2.80; p = .003). CONCLUSION: IBD, UC and Crohn's disease are associated with higher prevalence of RFT and higher percentage of RFT with periapical lesions. Dentists should consider these findings when caring for IBD patients by monitoring the evolution of periapical lesions of endodontically treated teeth.

The Application of Beta-Tricalcium Phosphate in Implant Dentistry: A Systematic Evaluation of Clinical Studies.

The demand for synthetic graft materials in implant dentistry is rising. This systematic review aims to evaluate the survival rate of dental implants placed simultaneously with bone regeneration procedures using the material ß-tricalcium phosphate, one of the most promising synthetic graft materials. The electronic search was conducted in PubMed, Scielo, and the Cochrane Central Register of Controlled Trials. Five randomized clinical trials, one non-randomized controlled clinical trial and four observational studies without control group were include. Implant survival rate and other clinical, radiographic, and histological parameters did not differ from those of implants placed simultaneously with another type of graft material, or placed in blood clots or natural alveolar ridges. Based on the available literature, ß-tricalcium phosphate seems to be a promising graft material in implant dentistry. Nevertheless, more randomized clinical trials, with long follow-up periods, preoperative and postoperative CBCT, and histological analysis, are necessary to assess its long-term behavior.

Frequency and type of digital procedures used for the intraoral prosthetic rehabilitation of patients with head and neck cancer: A systematic review.

STATEMENT OF PROBLEM: In spite of a digital workflow playing an important role in the intraoral prosthetic rehabilitation of patients with head and neck cancer, information about how it has been implemented and its clinical implications is sparse. PURPOSE: The purpose of this systematic review was to evaluate the use of a digital workflow in the intraoral prosthetic rehabilitation of patients with head and neck cancer by analyzing the frequency and type of the digital procedures used. MATERIAL AND METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The following terms were applied for the search conducted in the MEDLINE-PubMed, Cochrane, and SciELO databases: (prosthesis OR dental OR rehabilitation) AND (digital OR CAD-CAM OR intraoral scanner) AND (Cancer OR head neck). Articles that specified data on intraoral prosthetic treatment and analyzed the use of a digital workflow in the different prosthetic phases such as digital scanning and computer-aided design and computer-aided manufacturing (CAD-CAM) in patients with head and neck cancer were included. Data from the frequency and type of digital procedures were analyzed. RESULTS: Thirteen articles were included, and all had incorporated CAD-CAM techniques in at least 1 of the prosthetic treatment stages (scanning, design, and/or fabrication). Only 1 patient was rehabilitated by using a completely digital workflow. The most frequent prosthetic treatment was an obturator (82.6%). Regarding the image capture method, the most used method was cone beam computed tomography (CBCT) (60.9%). CONCLUSIONS: Most reports described the partial use of a digital workflow in the intraoral prosthetic rehabilitation of patients treated for head and neck cancer. A digital workflow is used for specific stages but not for the entire process. More studies are needed to evaluate digital systems, ideally comparing parameters with the conventional method, and to determine whether this technique has more relevant clinical implications.

Update on the management of anticoagulated and antiaggregated patients in dental practice: Literature review.

BACKGROUND: Oral antiplatelet and anticoagulant drugs are widely used in a large number of patients visiting the dentist, and there has been much controversy over the years towards their clinical management. The aim to carry out a literature review in order to develop an update on dental management in anticoagulated and / or anti aggregated patients, focusing on oral surgery. MATERIAL AND METHODS: A bibliographic search was carried out in PubMed on studies published between January 1, 2018, until December 10, 2020, using the keywords ("antiplatelet" OR "antiplatelets") AND ("dentistry"), and ("anticoagulant" OR "anticoagulants") AND ("dentistry"). RESULTS: The number of studies included in this review was 13, and the number of patients among all of them was 3.497 patients under treatment with some type of antithrombotic drug, who underwent different oral surgery treatments. CONCLUSIONS: There is a low risk of peri- and postoperative bleeding events during basic oral surgery treatments in antiplatelet or anticoagulated patients, which can be easily managed through the use of local haemostatic measures. Key words:Oral surgery, antiplatelet drugs, anticoagulant drugs, dental treatment.

USE OF LOCAL ANESTHETICS WITH A VASOCONSTRICTOR AGENT DURING DENTAL TREATMENT IN HYPERTENSIVE AND CORONARY DISEASE PATIENTS. A SYSTEMATIC REVIEW.

BACKGROUND: Coronary disease and Hypertension are highly prevalent health problems worldwide, with the latter being one of the most common diseases in patients visiting dental clinics. Local anesthetics (LAs) with vasoconstrictor agents (VC) are known to be commonly used in dental practice. For the above-mentioned reasons, dentists should know how to adapt and treat patients with these hazardous conditions. OBJECTIVE: The aim of this study was to find out if the use of local anesthetics (LAs) in combination with vasoconstrictor (VC) agents in dental treatment presents a risk in patient with a known history of Hypertension and/or Coronary disease. MATERIALS AND METHODS: This systematic review was conducted in accordance with The PRISMA guidelines and registered on the PROSPERO database (CRD42020187369). The search strategy was based on Mesh terms, Boolean operator AND, and the PICO model. It was designed to identify all the randomized clinical trials (RCTs) published in the last 30 years, which assessed whether the use of LA with VC agents in dental treatment produces a significant increase/decrease in hemodynamics in patients with known history of Hypertension and/or Coronary disease. The Cochrane Collaboration's tool was used to assess risk of bias of the included RCTs. RESULTS: An initial electronic search resulted in 87 papers; however only 9 RCTs met the inclusion criteria. There was a total of 482 subjects (N = 482), of which 412 had a known history of Hypertension or Coronary disease. CONCLUSIONS: According to the literature reviewed, the use of 1 to 2 cartridges of local anesthetics with 1:80,000, 1:100,000 or 1:200,000 epinephrine in patients with controlled Hypertension and/ or Coronary disease is safe. Randomized clinical trials are essential in determining the safety or risks associated with the use of LAs with VC agents in patients with poorly controlled Hypertension and Coronary disease.

Systemic Antibiotic Prophylaxis to Reduce Early Implant Failure: A Systematic Review and Meta-Analysis.

Systemic antibiotics are routinely prescribed in implant procedures, but the lack of consensus causes large differences between clinicians regarding antibiotic prophylaxis regimens. The objectives of this systematic review are to assess the need to prescribe antibiotics to prevent early implant failure and find the most appropriate antibiotic prophylaxis regimen. The electronic search was conducted in PubMed/MEDLINE, Scielo and Cochrane Central Trials Database for randomized clinical trials of at least 3 months of follow-up. Eleven studies were included in the qualitative analysis. Antibiotics were found to statistically significantly reduce early implant failures (RR = 0.30, 95% CI: 0.19-0.47, p < 0.00001; heterogeneity I2 = 0%, p = 0.54). No differences were seen between preoperative or both pre- and postoperative antibiotic regimens (RR = 0.57, 95% CI: 0.21-1.55, p = 0.27; heterogeneity I2 = 0%, p = 0.37). A single preoperative antibiotic prophylaxis dose was found to be enough to significantly reduce early implant failures compared to no antibiotic (RR = 0.34, 95% CI: 0.21-0.53, p < 0.00001; heterogeneity I2 = 0%, p = 0.61). In conclusion, in healthy patients a single antibiotic prophylaxis dose is indicated to prevent early implant failure.

Time-to-Treatment in Oral Cancer: Causes and Implications for Survival.

The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer.

An analysis of the prevalence of peripheral giant cell granuloma and pyogenic granuloma in relation to a dental implant.

BACKGROUND: The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants. It's important to know the characteristics present in these lesions and possible effects on the prognosis of dental implants. METHODS: An electronic search without time restrictions was done in the databases: PubMed/Medline. With the keywords "Granuloma" OR "Granuloma, Giant Cell" OR "peripheral giant cell" OR "Granuloma, Pyogenic" AND "Dental implants" OR "Oral implants". RESULTS: After applying the inclusion and exclusion criteria, a total of 20 articles were included, which reported 32 lesions (10 pyogenic granulomas, 21 peripheral giant cell granulomas and one peripheral giant cell granuloma combined with peripheral ossifying fibroma, all associated with implants). According to our review, these lesions are more frequent in males and in the posterior region of the mandible. Both excision and curettage of the lesion, compared to only excision, presented similar recurrences (40%). Explantation of the implant was performed in 41% of cases without additional recurrences. The results are not statistically significant when comparing one lesion to the other in terms of explantation (p = 0.97), recurrence (p = 0.57) or bone loss (p = 0.67). CONCLUSIONS: The main therapeutic approach is tissue excision. The lesions show a high recurrence rate (34.4%), which often requires explantation of the associated implant. This recurrence rate is not affected by curettage after excision.

COVID-19 and oral lesions, short communication and review.

BACKGROUND: The COVID-19 disease first appeared in December 2019 in Wuhan, China. The World Health Organization (WHO) declared the pandemic in March 2020, with 40 million cases and a million deaths in October 2020. COVID-19 also includes manifestations on the skin and mucous mucosal membrane. Objective: To evaluate the prevalence of the oral lesions associated to COVID-19 disease; and evaluate their clinical presentation and the hypothesized etiology. MATERIAL AND METHODS: An electronic literature search was performed in PubMed, Scopus and Índice Médico Español databases. The following combination of keywords and Boolean operators were used: "COVID-19 AND oral manifestations"; "COVID-19 AND oral lesions"; "COVID-19 AND mucosal lesions" ; "COVID-19 AND mucosal manifestations"; "SARS-COV-2 AND oral manifestations"; "SARS-COV-2 AND oral lesions"; "SARS-COV-2 AND mucosal lesions"; "SARS-COV-2 AND mucosal manifestations". Furthermore, the bibliography was reviewed to manually include additional articles. The risk of bias in individual studies was assessed by two blinded reviewers using the Joanna Briggs Institute (JBI) and the evidence levels of the articles found will be cataloged according to the level of evidence and grade of recommendation of Oxford Centre for Evidence-Based Medicine (CEBM). RESULTS: 249 articles were found in the Medline / Pubmed database. There are no additional articles in the Scopus and Índice Médico Español databases. We selected 14 articles plus 5 more articles due to manual searching. Patients presented a wide variety of oral manifestations. The most prevalent were lesions with a solution of continuity (n = 48, 73.85%) and the most frequent area was the tongue (n = 41, 52.56%). The preferred treatment for the lesions is a localized one by using rinses. CONCLUSIONS: To conclude, after the bibliographic review was performed, we can expect that the COVID-19 disease can cause cutaneous and mucosal lesions as secondary manifestations. Despite more studies being needed to confirm this. Key words:COVID-19, SARS-COV-2, oral lesions, oral manifestations.

Head and neck cancer and non-steroidal anti-inflammatory drugs: Systematic review and meta-analysis.

The objective was to assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on head and neck cancer (HNC) outcomes. A systematic review was conducted following the PRISMA guidelines. The MEDLINE and the Cochrane Central Register databases were searched. Risk of bias was assessed by the Cochrane Collaboration's tool and by the Newcastle-Ottawa Scale. Meta-analyses were performed with the RevMan software. Seventeen articles met the inclusion criteria. Quality scores for observational studies ranged between 5 and 8 stars and the RCT was assessed as high risk of bias. NSAIDs use was associated with a 13% risk reduction of HNC (OR: 0.87 95% CI 0.77-0.99). NSAIDs use was associated with a 30% reduced cancer-specific mortality and with a 40% decreased risk on disease-recurrence. NSAIDs may have a modest protective effect on HNC risk and a positive impact on cancer-specific survival and disease-recurrence. The findings do not support a protective role of aspirin on HNC outcomes.

Evaluation of Bone Gain and Complication Rates after Guided Bone Regeneration with Titanium Foils: A Systematic Review.

Guided bone regeneration techniques are increasingly used to enable the subsequent placement of dental implants. This systematic review aims to analyze the success rate of these techniques in terms of bone gain and complications rate using titanium membranes as a barrier element. Electronic and hand searches were conducted in PubMed/Medline, Scielo, Scopus and Cochrane Library databases for case reports, case series, cohort studies and clinical trials in humans published up to and including 19 September 2020. Thirteen articles were included in the qualitative analysis. Bone gain both horizontally and vertically was comparable to that obtained with other types of membranes more commonly used. The postoperative complication rate was higher that of native collagen membranes and non-resorbable titanium-reinforced membranes, and similar that of crosslinked collagen membranes and titanium meshes. The survival rate of the implants was similar to that of implants placed in native bone. Due to the limited scientific literature published on this issue, more randomized clinical trials comparing occlusive titanium barriers and other types of membranes are necessary to reach more valid conclusions.

Apical periodontitis and glycemic control in type 2 diabetic patients: Cross-sectional study.

BACKGROUND: The objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control. MATERIAL AND METHODS: In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis. RESULTS: The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ≥ 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 - 3.09; p = 0.31). CONCLUSIONS: The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients. Key words:Apical periodontitis, diabetes mellitus, endodontic medicine, glycated haemoglobin.

Survival of Dental Implants in Oncology Patients versus Non-Oncology Patients: A 5-Year Retrospective Study.

Patients with a history of cancer are increasingly common in the dental office. Treating cancer patients requires a multidisciplinary team, which should include the dentist, in order to control the complications that occur in the oral cavity and also to recover the patient undergoing treatment in any of its types: surgical, medical, radiotherapeutic, or its possible combinations. Dental implants can be a safe and predictable treatment option for prosthetic rehabilitation. The aim of this paper is to describe in retrospect the success rate of osseointegrated implants in oncology and non-oncology patients placed by the Master of Dentistry in Oncology and Immunocompromised Patients, as well as the Master of Medicine, Surgery and Oral Implantology of the University of Barcelona Dental Hospital, between July 2011 and March 2016. 466 patients were reviewed, with a total of 1405 implants placed, considering the oncological history of the patients and the implant success rate. The total success rate in the concerned period was 96.65%. When comparing cancer patients with healthy ones, the success rate has been 93.02% in the first case, and 97.16% in the latter. According to the literature review, our results encourage implant placement in cancer patients, it is important to recognize that this is an analysis of a complex care pathway with a large number of confounding variables. However, the findings should not be considered as generalizable.