Mandibular dental implant placement immediately after teeth removal in head and neck cancer patients

Alberga, Jamie; Korfage, Anke; Bonnema, Ilse; Witjes, Max J. H.; Vissink, Arjan; Raghoebar, Gerry M.

doi:10.1007/s00520-020-05431-y

Cited by 14 publications

(33 citation statements)

References 39 publications

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“…15 In patients with head and neck cancer that need to undergo radiotherapy, the observation of previously installed implants should be an important consideration. 7,8 Given the lack of protocols that aim to address such situations, the irradiation field should be limited as much as possible to avoid implant areas, and patients need to return frequently to the dental office to analyse implant stability.…”

Section: Groupsmentioning

confidence: 99%

“…[2][3][4][5] However, few studies have evaluated the presence of osseointegrated implants in irradiated bone areas. 1,4,6,7 The presence of titanium implants in irradiated areas can create a deleterious effect on bone tissue.…”

Section: Introductionmentioning

confidence: 99%

“… 2 – 5 However, few studies have evaluated the presence of osseointegrated implants in irradiated bone areas. 1 , 4 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

“… 2 , 4 During head and neck tumour ablative surgery, dental implants can be installed in areas that need to be treated using radiotherapy. 1 , 4 , 6 , 7 The stability of titanium implants in the osseointegration process is compromised by radiation in a dose-dependent manner. 11 , 12 Additionally, there is no consensus regarding the impact of ionizing irradiation on the functionality or survival of the implant installed in the irradiation field.…”

Section: Introductionmentioning

confidence: 99%

“… 5 , 10 Studies have been carried out to evaluate implant survival in previously irradiated areas, 2 , 3 , 5 but there are limited data on the effect of backscattered radiation on the osseointegration process of implants placed before ionizing radiation. 1 , 4 , 5 , 7 , 8 Although backscattering effects around the implant can be a problem for individuals with implant rehabilitation, 1 , 4 , 10 the risk of radionecrosis is not significantly higher than that for postimplantation radiotherapy. 1 , 4 , 10 Therefore, the aim of this study was to evaluate the effects of ionizing radiation on the rabbit bone surrounding an implant using microcomputed tomography (micro-CT) and biomechanical analysis.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Soares

Limirio

et al. 2020

J. Appl. Oral Sci.

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Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant Objective: This study analyzed the effect of ionizing radiation on bone microarchitecture and biomechanical properties in the bone tissue surrounding a dental implant. Methodology: Twenty rabbits received three dental morse taper junction implants: one in the left tibia and two in the right tibia. The animals were randomized into two groups: the nonirradiated group (control group) and the irradiated group, which received 30 Gy in a single dose 2 weeks after the implant procedure. Four weeks after the implant procedure, the animals were sacrificed, and the implant/bone specimens were used for each experiment. The specimens (n=10) of the right tibia were examined by microcomputed tomography to measure the cortical volume (CtV, mm 3), cortical thickness (CtTh, mm) and porosity (CtPo, %). The other specimens (n=10) were examined by dynamic indentation to measure the elastic modulus (E, GPa) and Vickers hardness (VHN, N/mm 2) in the bone. The specimens of the left tibia (n=10) were subjected to pull-out tests to calculate the failure load (N), displacement (mm) up to the failure point and interface stiffness (N/mm). In the irradiated group, two measurements were performed: close, at 1 mm surrounding the implant surface, and distant, at 2.5 mm from the external limit of the first measurement. Data were analyzed using one-way ANOVA, Tukey's test and Student's t-test (α=0.05). Results: The irradiated bone closer to the implant surface had lower elastic modulus (E), Vickers hardness (VHN), Ct.Th, and Ct.V values and a higher Ct.Po value than the bone distant to the implant (P<0.04). The irradiated bone that was distant from the implant surface had lower E, VHN, and Ct.Th values and a higher Ct.Po value than the nonirradiated bone (P<0.04). The nonirradiated bone had higher failure loads, displacements and stiffness values than the irradiated bone (P<0.02). Conclusion: Ionizing radiation in dental implants resulted in negative effects on the microarchitecture and biomechanical properties of bone tissue, mainly near the surface of the implant.

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Section: Groupsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 2 – 5 However, few studies have evaluated the presence of osseointegrated implants in irradiated bone areas. 1 , 4 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Soares

Limirio

et al. 2020

J. Appl. Oral Sci.

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Dental Implants and Systemic Diseases

Mosaddad,

Keyhan,

Fallahi

et al. 2024

Handbook of Oral and Maxillofacial Surgery and Implantology

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Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: a systematic review and meta-analysis

et al. 2021

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Objectives This systematic review assesses dental implant survival, calculates the incidence rate of osteoradionecrosis, and evaluates risk factors in irradiated head and neck cancer patients. Materials and methods Various databases (e.g., Medline/Embase using Ovid) and gray literature platforms were searched using a combination of keywords and subject headings. When appropriate, meta-analysis was carried out using a random effects model. Otherwise, pooled analysis was applied. Results A total of 425 of the 660 included patients received radiotherapy. In total, 2602 dental implants were placed, and 1637 were placed in irradiated patients. Implant survival after an average follow-up of 37.7 months was 97% (5% confidence interval, CI 95.2%, 95% CI 98.3%) in nonirradiated patients and 91.9% (5% CI 87.7%, 95% CI: 95.3%) after an average follow-up of 39.8 months in irradiated patients. Osteoradionecrosis occurred in 11 cases, leading to an incidence of 3% (5% CI 1.6%, 95% CI 4.9%). The main factors impacting implant survival were radiation and grafting status, while factors influencing osteoradionecrosis could not be determined using meta-analysis. Conclusion Our data show that implant survival in irradiated patients is lower than in nonirradiated patients, and osteoradionecrosis is—while rare—a serious complication that any OMF surgeon should be prepared for. The key to success could be a standardized patient selection and therapy to improve the standard of care, reduce risks and shorten treatment time. Clinical relevance Our analysis provides further evidence that implant placement is a feasible treatment option in irradiated head and neck cancer patients with diminished oral function and good long-term cancer prognosis.

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Mandibular dental implant placement immediately after teeth removal in head and neck cancer patients

Cited by 14 publications

References 39 publications

Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Dental Implants and Systemic Diseases

Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: a systematic review and meta-analysis

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