Outcomes of dental and craniofacial osseointegrated implantation in head and neck cancer patients

Abstract

Background Treatment of head and neck cancer may result in disfiguring and debilitating anatomical changes. Osseointegrated implants may be used in these patients to facilitate attachment of implant‐retained dentures or cosmetic prostheses. Methods A retrospective audit was performed, reviewing the treatment of patients who received dental or craniofacial osseointegrated implants during treatment of head and neck cancer. Results One hundred sixty implants were inserted in 54 patients with oral, nasal, orbital, or auricular defects. Overall, 85% of implants were successful after mean follow‐up of 25.7 months. The brand of implant used was shown to impart a statistically significant implant survival difference, and orbital implants had poorer survival compared to nonorbital implants. There was a statistical insignificant implant survival advantage in both nonsmokers and patients who did not undergo radiotherapy. Conclusions Dental and craniofacial osseointegrated implants may be reliably used in patients with head and neck cancer. However, further research is required to clarify the role of smoking in osseointegrated implant failure.

Dental implants in patients with head and neck cancer—A systematic review and meta‐analysis of the influence of radiotherapy on implant survival

“…Whether an implant was loaded or not and the time interval before loading were also found to be influencing the outcome. Adverse to that Moore et al (2019), Woods et al (2019), Jacobsen et al (2014) and Curi et al (2018) found no statistically significant difference in implant placement for the respective factor examined. In those studies, there was neither a difference in implant placement prior to or after radiotherapy (Jacobsen et al, 2014; Moore et al, 2019), nor in the time interval before placement after radiation (Curi et al, 2018).…”

“…However, 18 studies investigated in the current literature research were not used for meta‐analysis. Besides the reasoning of too short of a follow‐up (Alberga et al, 2020; Burgess et al, 2017; Ch'ng et al, 2016; Gander et al, 2014; Hessling et al, 2015; Moore et al, 2019; Pompa et al, 2015; Woods et al, 2019), the second reason for exclusion was that the studies only assessed implants placed in irradiated bone, which means they were lacking a non‐irradiated control group (Buurman et al, 2013; Curi et al, 2018; Di Carlo et al, 2019; Nack et al, 2015; Neckel et al, 2020; Papi et al, 2019; Rana et al, 2016; Sandoval et al, 2020). Ettl et al (2020) were reporting implant success using a modified version of the Albrektsson criteria (Albrektsson et al, 1986), and their study was therefore excluded.…”

“…This was countered by only three studies in which the implants were inserted prior to irradiation (Alberga et al, 2020; Korfage et al, 2014; Sandoval et al, 2020). Furthermore, three studies reported implant placement both before and after radiotherapy (Ch'ng et al, 2016; Laverty et al, 2019; Moore et al, 2019). For four studies, information about the time of implantation was missing (Buurman et al, 2013; Fierz et al, 2013; Patel et al, 2020; Woods et al, 2019).…”

“…The opinions on the timing of implant placement vary. Some authors advocate immediate implant placement during resective surgery to shorten the interval of time between the resection and dental rehabilitation (Alberga et al, 2021; In't Veld et al, 2021;Moore et al, 2019; Woods et al, 2019). In addition, in case of adjuvant radiotherapy, immediate implant placement prior to the radiation can be beneficial as the implant healing and osseointegration takes place in non‐irradiated bone (In't Veld et al, 2021; Panchal et al, 2020; Schepers et al, 2006).…”

Clinical long-term and patient-reported outcomes of dental implants in oral cancer patients

“…Smokers were excluded for participation and soft-tissue augmentations were performed in case of insufficient soft-tissue conditions. Smoking is known to negatively influence endosseous implant survival aside from other variables such as radiation [ 20 ].…”