With respect to the critical patient selection including a high number of patients with minor and major augmentations, the 10-year clinical use of the studied implant system showed acceptable results.
Aim: The aim of this retrospective study was to investigate prognostic parameters for the rehabilitation of mandibular continuity defects with free autologous bone and dental implants for patients after intraoral squamous cell carcinoma. Methods: Following potential prognostic factors for implant survival were analyzed: bony bed (local bone versus augmented iliac crest bone), radiation dose (no radiation, <50 Gy, ≥50 Gy) and implant dimensions. Kaplan-Meier survival estimates of the inserted implants were performed. Results: After 5 years, the cumulative survival rate of all investigated implants was 82.6%. Dental implantation into augmented bone resulted in a significantly lower survival rate (78.4%), compared to original local bone (92.8%). Modifications of implant dimensions as well as radiation therapy showed no significant impact on implant survival. Conclusion: For the investigated compromised collective, our results reveal a satisfactory long-term survival rate of dental implants even in augmented bone and underline the value of dental implantation for the functional rehabilitation of cancer patients.
Vertical distraction by means of implant distractors could be performed with reasonable success in tumor patients with box-shaped resection defects or undercontoured bone grafts. Overall morbidity was very low. Even though blood supply is continuously maintained in distraction osteogenesis, bone resorption remains a critical issue for this reconstruction technique too.
Background and purpose
The aim of this clinical study was to investigate the clinical long-term and patient-reported outcome of dental implants in patients with oral cancer. In addition, analysis of the influence of radiation therapy, timing of implant insertion, and augmentation procedures on implant survival was performed.
Material and methods
This retrospective study investigated the clinical outcome of 711 dental implants in 164 oral cancer patients, inserted by experienced surgeons of the Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Germany. Oral health-related quality of life (OHRQoL) was evaluated.
Results
Cumulative 5-year and 10-year implant survival rates for all included implants were 87.3% and 80.0%. Implants placed straight after ablative surgery (primary implant placement) and implants placed after completing the oncologic treatment (secondary implant placement) showed a comparable implant survival (92.5% vs. 89.5%; p = 0.635). Irradiation therapy had no significant influence on implant survival of secondary placed implants (p = 0.929). However, regarding implant site (native bone vs. augmented bone) and radiation therapy (non-irradiated bone vs. irradiated bone), implants inserted in irradiated bone that received augmentation procedures showed a statistically significant lower implant survival (p < 0.001). Patients reported a distinct improvement in OHRQoL.
Conclusions
Promising long-term survival rates of dental implants in patients after treatment of oral cancer were seen. In addition, patients benefit in form of an improved OHRQoL. However, bone augmentation procedures in irradiated bone may result in an impaired implants’ prognosis.
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