The Impact of Cancer Treatment On Oral Structures and the Facial Part of the Skull — Implications for Prosthetic Treatment and Oncological Risk

PURPOSE OF REVIEW: This study aims to identify complications and difficulties in oncology patients undergoing dental implant osseointegration, considering the impact of treatment on the microarchitecture of the craniofacial region, the oral cavity microbiome, and oral cavity inflammation. RECENT FINDINGS: Surgical resection, radiotherapy, chemotherapy, and targeted therapies significantly affect the condition of bones, mucous membranes, and soft tissues, and consequently the possibilities and limitations of prosthetic rehabilitation. Chemotherapy significantly affects calcium and phosphorus metabolism. It has been observed that there is an increased risk of fractures, as well as changes in their microarchitecture, and a reduction in the resorption of biomaterials after transplantation has been observed, impairing bone repair in critical defects. These changes may also affect the processes of osteogenesis and osteoclastogenesis and lead to osteoblast cell apoptosis. The impact of therapy on the oral microbiota, as well as on increased inflammation and oxidative stress in the oral cavity, is also significant. These changes can lead to difficulties in implant osteointegration, as well as opportunistic infections, which reduce the patient's prognosis for implant acceptance. Complications after implantation in oncology patients may include inflammation of the mucosa around the implant and inflammation of the tissues around the implant, soft tissue ulceration, marginal bone loss, and partial loss of osseointegration. Due to the complexity of the processes occurring in the oral cavity of oncology patients, prosthetic treatment planning should be interdisciplinary and involve an oncologist, surgeon, prosthodontist, and conservative dentist.