Implant survival rate after oral cancer therapy: A review (original) (raw)
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Nigerian Journal of Surgery, 2016
In patients undergoing head and neck surgery for various pathologic conditions, implants are one of the best restorative options and are increasingly widely used. [1] The healing process of a wounded, diseased or an injured bone is a normal phenomenon. It begins with fibrin clot formation that alters the normal flow of blood and feeds and supports the osteoprogenitor cells. [2] Successful implant insertion occurs in human bone due to optimum osseointegration at the junction or interface of bone and implants. [3] Most common form of malignancy occurring in humans is the head and neck cancer with over 0.5 million new cases occurring every year. The treatment modality for malignant lesions involves most commonly surgical intervention in combination with radiotherapy. Since, surgical therapy for cancer patients' results in loss of considerable amount of tissue, oral rehabilitation by artificial prosthesis, implants, etc., is a necessary procedure to redress both functional and esthetic disabilities. Artificial prosthesis has certain side-effects such as having the capability of producing xerostomia, mucositis, and altering the healing process in irradiated tissues. Dental implants avoid these side-effects to a much extent but successfully placing implants in patients treated for oral cancer is itself a difficult task because some have had radiation exposure in the tissues. [4] Patients exposed to radiotherapy for treatment of cancer have reduced healing capacity due to progressive fibrosis of vasculature. Radiation
Osseointegrated Implant Rehabilitation of Irradiated Oral Cancer Patients
Journal of Oral and Maxillofacial Surgery, 2012
The aim of this study is to analyze implant survival in patients who received radiotherapy treatment for oral malignancies and in patients who had suffered mandibular osteoradionecrosis. Materials and Methods: We reviewed retrospectively 225 implants placed in 30 patients who had received radiotherapy as part of the oncologic treatment. Radiation doses ranged between 50 and 70 Gy. 39 implants were placed after a combined treatment of radiotherapy and chemotherapy. Data referred to tumour type and reconstruction, presence of osteoradionecrosis, region of implant installation and type of prostheses were recorded. Survival rates were calculated with cumulative Kaplan-Meier survival curves and compared between different groups with a log-rank test. Results: 152 osseointegrated implants were placed in patients who presented previous reconstruction procedure. Five patients developed osteorradionecrosis as a complication of the radiotherapy treatment. Once osteoradionecrosis had healed in these patients, 41 implants were installed. The overall 5 year survival rate in irradiated patients was 92.6%. Irradiated patients had a marginally significantly higher implant loss than non-irradiated patients. (p ϭ 0.063). The 5 year survival rate in the osteoradionecrosis group was of 48.3% and in the non-osteoradionecrosis group 92.3%, with a statistically significant difference between both groups. (p ϭ 0.002). Conclusion: Osseointegrated implants enhance oral rehabilitation in most irradiated patients, even being an acceptable option for patients who had suffered osteoradionecrosis. Totally implantsupported prostheses are recommended after irradiation providing functional, stable and aesthetically satisfactory rehabilitation.
Médecine Buccale Chirurgie Buccale
Introduction: The placement of dental implants in irradiated bone has allowed functional rehabilitation for many oral cancer patients. Nonetheless, there is only few data about implant failure in irradiated tissues and their consequences. This retrospective study aims to highlight the rate and circumstances of implant failure. Material and method: Patients treated with external radiotherapy for oral carcinoma and who received dental implants were included. Patients reconstructed with free bone flaps were excluded. Results: Eighteen patients were included. Forty implants were placed between 2004 and 2007, 8 failed, of whom one osteoradionecrosis was observed. Time interval between radiotherapy and implantation was 44.6 (6–182) months. Mean dose was 51.8 (50–66) Gy. Discussion: In the series, the implant failure rate is 20%, which corroborates the literature's data. Failures occur more often for doses over 50 Gy. The placement of dental implant in irradiated bone leads to soft tis...
A Review of the Success Rate of Dental Implants in Patients Undergoing Radiotherapy and Chemotherapy
ACTA SCIENTIFIC OTOLARYNGOLOGY (ASOL), 2022
Introduction: According to the World Health Organization, the incidence of head and neck cancers, both primary and secondary (metastatic), is increasing. Currently, the main treatments for this complication are radiotherapy and chemotherapy. On the other hand, the success of implant treatment in these patients due to the cellular changes is a very significant point that should be considered. Objective: The aim of this study was to review the success rate of dental implants in patients undergoing radiotherapy and chemotherapy. Materials and Methods: This study was a narrative review. In this study, research published in PubMed, Google Scholar, and Scapus databases has been reviewed by a review method and with a keyword search strategy. Results: 4320 articles were found from the mentioned databases that after deleting unrelated research (3101 cases) and duplicate research (1050 cases), 105 articles remained for final review. Then, those that were presented in the scientific conference and were in the form of abstracts or did not have a correct statistical population were excluded from the study (90 cases). Finally, 15 articles in this study were reviewed. Conclusion: The survival rate of dental implants may be negatively affected by radiotherapy; however, implants can remain osteointegrated and remain functionally stable and, therefore, can be a good treatment option for rehabilitation and improving the quality of life of cancer patients. The use of bone grafts and higher doses of radiation in the jaw area can be negative prognostic factors.
The Influence of Radiation Therapy on Dental Implantation in Head and Neck Cancer Patients
Journal of Analytical Oncology
Radiotherapy is used to treat patients with head and neck cancers as a primary therapy or as an adjuvant to surgery or chemotherapy. Irradiation results in several complications that can be very overwhelming to the patient. Frequently there is loss of function due to tooth loss, compromised aesthetics, pain and discomfort from xerostomia and mucositis, it also significantly impacts the quality of life. A major advance in dentistry is the successful rehabilitation and replacement of lost teeth by osseointegrated implants. However, the risk of osteoradionecrosis and failure of osseointegration are barriers to implant therapy for those irradiated patients. The aim of this review article is to primarily find out whether the radiotherapy used in the treatment of head and neck cancer patients can affect the success and survival of dental implants according to different studies, and also, to highlight some other pertinent factors that may concurrently influence these implantation. The prim...
Rehabilitation with dental implants of oral cancer patients
Journal of Cranio-Maxillofacial Surgery, 1999
The aim of this study was to evaluate the risks and complications of rehabilitation with dental implants after tumour surgery and radiotherapy. After a disease-free survival of 18 months, 29 patients who had undergone oral cancer treatment were rehabilitated with dental implants. The complication rate of implants in irradiated, non-irradiated and grafted bone was analyzed at least 3 years after implant placement. In the healing period, 28.6% of the implants in irradiated bone and 8.4% in non-irradiated bone showed soft tissue complications. Of the implants, 26.7% in the irradiated and 14.7% in the non-irradiated mandibular bone were lost in the first 36 months after placement. Thirty-one point two percent of implants inserted in non-irradiated bone grafts were affected and did not osseointegrate. Of 109 inserted implants, 70 were suitable for prosthetic rehabilitation. There are high complication rates after implant placement in oral cancer patients. Irradiation adversely affects soft tissue healing. Osseointegration is frequently disturbed, especially when implants were placed in non-vascularized bone grafts.
Open Journal of Stomatology, 2015
Objective: To investigate the clinical performance of implants with chemically modified surfaces in irradiated bone in a period of five-years. Patients & Methods: 15 (6 females, 9 males, 50.2 years with a range of 38 -60 years) patients who had been operated for oral tumors and had undergone radiotherapy were enrolled and 40 SLActive surface implants were placed (24 in the maxilla, 16 in the mandible). Implants were allowed to integrate for a period of 90 days and the stability of the implants was measured with Resonance Frequency Analyzer/Osstell™ Mentor (Integration Diagnostics, Savedalen, Sweden) at implant placement, 30 days later and at the end of the 90 th day. Patients follow up periods after the implant placement varied from 20 months to 60 months (mean: 45 months). Results: Two implants were lost in maxilla in healing period as a result of osseointegration failure. The survival rate was 95%. During the observation period, totally 4 implants were lost. The overall success rate was 90%. 3 of the lost implants were in maxilla and one was in mandible. The initial ISQ values of the implants differed from 20 -71; the second values were between 24 -71 and the last values were between 30 -89. The implants which were lost could not show a value greater than 35. Conclusion: There was no any complication on the SLActive surface implant placed bones due to irradiation. Within the limitations of this study, it may be concluded that osseointegrated implants can be placed in irradiated bones, unless a careful patient selection and treatment planning is performed.
Oral Implants in Radiated Patients: A Systematic Review
Purpose: Oral malignancy is often treated with a combination of surgery and radiation therapy (RT). The aim of this systematic review was to examine the effects of pre-and postimplantation RT on dental implant failure. Materials and Methods: The literature published from 1990 through 2006 was reviewed for studies assessing pre-and postimplantation RT. Potential studies were identified by searches of PubMed, SCIRUS, and the Cochrane Central Register of Controlled Trials (CENTRAL). The incidence of implant failure has been linked to the following variables: post-versus preimplantation RT, site of implant placement, RT dose, delay from RT to implant placement, and timing of implant failure after placement. Results: Similar failure rates were found for implants placed post-RT compared to those placed pre-RT (3.2% and 5.4%). In preimplantation RT, the implant failure rate was lower for the mandible (4.4%) in comparison to the maxilla (17.5%; OR = 4.63; 95% CI: 2.25 to 9.49). Other results did not reach statistical significance. No failures were observed in association with an RT dose lower than 45 Gy. All implant failures observed occurred within 36 months after RT, and most occurred between 1 and 12 months after placement. Conclusion: Notwithstanding the low number of implants evaluated, this review showed similar failure rate for implants placed post-RT and those placed pre-RT (3.2% and 5.4%, respectively). (Systematic Review) INT J ORAL MAXILLOFAC IMPLANTS 2007;22:616-622
Implant Therapy in Irradiated Patients
Journal of Craniofacial Surgery, 2011
In this multicenter study, submerged implants were prospectively followed to evaluate their long-term prognosis in irradiated patients. In a total of 77 patients treated for oral or neck cancer, 188 implants were consecutively placed. After a healing period, the successfully integrated implants were restored with 69 removable and 38 fixed restorations. The implants cumulative survival and success rates were evaluated over a period of at least 36 months. In addition, cumulative success rates were calculated for implant subgroups divided per implant site (mandible or maxilla), radiation dosage, and the time interval between the last irradiation and implant placement. During the healing period, 20 implants did not successfully integrate, whereas 168 implants were classified as success (including both survival and success rates). The analysis of implant subgroups showed slightly more favorable cumulative success rate for mandibular implants (98.4%) compared with maxillary implants (57.1%) and clearly better success rate for a radiation dosage minor of 50-Gy doses. A time greater than 12 months as interval between last irradiation and implant placement seems not to promote better clinical results.