Explained: What is ZIP technique, an innovation for oral cancer treatments

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New Delhi: Oral cancer remains a significant health concern worldwide, with its prevalence increasing steadily over recent years. Fortunately, advancements in technology have boosted the field of oral cancer treatment, offering innovative solutions that enhance patient outcomes and quality of life.

In a significant advancement in oral cancer treatment, two patients—a 37-year-old woman and a 56-year-old man from Bangalore underwent a modified jaw-in-a-day surgeries. Both patients successfully underwent removal of their maxilla (upper jaw cancer), virtual surgical planning and 3D printing aided dental implant placement, free flap reconstruction and denture placement all in a single stage procedure.

Oral cancer: Single surgery with ZIP flat technique, virtual surgical planning and 3D printing

Conventional workflows result in patients with upper jaw cancers receiving teeth on average a year or more after completion of surgery, with many not actually receiving teeth in the reconstructed site. Using a modification of the zygomatic implant perforated (ZIP) flap technique, virtual surgical planning and 3D printing, all these are now done in a single surgery. This technique allows patients to receive their radiotherapy as required with no disruption to their cancer treatment.

Sophisticated jaw reconstruction and dental rehabilitation procedures are well-established however this workflow and its technical modifications are unique. Single-stage jaw reconstruction has several advantages: immediate restoration of form and function, better social functioning, avoiding secondary procedures and surgeries, reduced cost, better precision, and a higher chance of success since the implants have integrated with the bone by the time the effects of radiotherapy start to appear.

ZIP modifies procedure

Dr Narayana Subramaniam, Director – Head & Neck Surgery-Oncology, SPARSH Hospital, Bangalore, “This transformative approach, called the modified ZIP procedure, focuses on making things easier for patients. The innovative technological advancement is a big change in how we treat oral cancer, helping patients not only with their cancer but also providing them with immediate dental rehabilitation. By making the treatment quicker and compatible with radiotherapy, we’re aiming to give patients a full set of functional teeth sooner, which can really improve their lives as they recover and get their confidence back.”

The traditional mindset has been that patients with oral cancer can be cured and then we can restore their teeth. However, it doesn’t happen, either because of the financial burden of cancer, not wanting additional procedures or because the side effects of radiotherapy make secondary procedures difficult or unsuccessful.

With virtual surgical planning and 3D printing we can get millimetric precision and even audit where the radiotherapy dose delivery will be and predict how they will affect the tissue around implants, concludes Dr Narayana.

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