Effectiveness of dental implants in patients undergoing radiotherapy for head and neck cancer: An umbrella review

Abstract

ObjectiveThe objective of this overview is to evaluate the effectiveness of dental implants placed in patients who underwent radiotherapy for the treatment of head and neck cancer, as well as to assess the methodological quality of the included systematic reviews.MethodsThe study was conducted in four PubMed, Lilacs, Dare Cochrane and Google Scholar databases until July 2022, using the descriptors “Radiotherapy,” “Dental implants,” and “Head and Neck Cancer.” Results: 958 studies were found in the initial search and after applying the inclusion and exclusion criteria, fifteen systematic reviews were selected to compose this overview and had their methodological quality evaluated by the AMSTAR 2 tool.Results24,996 implants in 5487 patients were evaluated with a rate of success rate of 86.2% in patients who underwent radiotherapy and 95.2% in patients who did not undergo radiotherapy. Only one of the systematic reviews was of high quality according to AMSTAR 2.ConclusionOral rehabilitation with dental implants in patients with a history of head and neck cancer undergoing radiotherapy is a valid therapy. However, given the level of evidence found, further studies with better design are necessary to provide greater confidence in the clinical decision.

The effects of high-dose radiation therapy on bone: a scoping review

“…Camolesi et al [ 32 ], focusing on reports with 5 year data, found 93% vversus 98% implant survival in irradiated and non-irradiated patients, respectively. Zarzar et al [ 33 ] published in 2023 an umbrella review of meta-analyses on the effects of RT on the success of dental implants. They concluded that implantation in irradiated bones had an 86% success rate versus a 95% success rate in normal bone.…”

Comment on: Effectiveness of dental implants in patients undergoing radiotherapy for head and neck cancer: An umbrella review (doi: 10.1111/scd.12840)

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Dear Editor,We read with great respect the umbrella review by Zarzar et al on the efficacy of implant applications in patients with head and neck cancer (HNC) who have undergone radiotherapy (RT), which is not well-defined and holds many uncertainties. 1 The primary objective of this study was to determine the long-term success rate of dental implants in patients who underwent RT for HNC, while the secondary objective was to examine the incidence of implant-related complications in this patient population. The authors examined 24,996 implants in 5487 patients over one month to 23 years, with an 86.2% success rate for patients who received RT and 95.5% for those who did not.

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