Updated Clinical Considerations for Dental Implant Therapy in Irradiated Head and Neck Cancer Patients

Tanaka, Fds RCSEd Takako Imai; Chan, Hsun‐Liang; Tindle, D; MacEachern, Mark; Oh, Tae Ju

doi:10.1002/9781119115397.ch27

Cited by 12 publications

(17 citation statements)

References 59 publications

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“…Several authors have proposed guidelines for prosthodontic rehabilitation of HNC patients, based primarily on the cumulative dose received at the implantation site . There is currently no consensus regarding the ideal timing of implant surgery.…”

Section: Discussionmentioning

confidence: 99%

Postimplantation radiation therapy in head and neck cancer patients: Literature review

et al. 2020

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There is no recommendation regarding the timing for implant surgery in patients with head and neck cancer (HNC) who require postoperative radiation therapy (RT). This systematic review focused on the literature about the outcomes of implants placed during ablative surgery in patients with HNC who underwent postoperative RT. Implants placed after radiation therapy and implants placed in reconstructed jaws were excluded. Four comparative studies involving 755 native mandible primary implants were analyzed. The survival rate with postimplantation RT was 89.6% vs 98.6% in patients with no additional radiation. The overall success of implant‐retained overdenture in patients with RT performed postimplantation was 67.4% vs 93.1% in patients with implant surgery that was carried out 1 year after the completion of radiation therapy. Only five cases of osteoradionecrosis (ORN) of the jaw were reported. The outcomes for implant survival rates appear to be positive for irradiated implants.

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Section: Discussionmentioning

confidence: 99%

Postimplantation radiation therapy in head and neck cancer patients: Literature review

et al. 2020

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“…The use of orofacial and intraoral implants in prosthetic reconstruction has increased significantly in recent decades because of the development of restorative materials and surgical techniques. The implant‐supported prostheses seem to be a viable option, especially when the adverse effects of RT, such as xerostomia or friable mucosa, along with a compromised oral anatomy, hinder the use of conventional removable prostheses . Javed et al concluded that doses of radiation ≥50 Gy and ≤65 Gy did not result in any detrimental effects on the osseointegration of dental implants.…”

Section: Discussionmentioning

confidence: 99%

“…Ihde et al concluded that doses >50 Gy decreased dental implant survival rates. Tanaka et al found that the placement of dental implants in the anterior mandible and a cumulative radiation dose that was <50 Gy resulted in a good survival rate for dental implants if the implants were inserted 12 months after RT.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the anterior mandibular region was irradiated with doses of 40 to 47 Gy in both tumor locations (see Figure ). This resulted in a positive prognosis according to a study by Tanaka et al for the installation of dental implants. Radiation has been shown to cause bone abnormalities and to increase the risk of implant loss in areas within the irradiated field.…”

Section: Discussionmentioning

confidence: 99%

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Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity‐modulated radiotherapy

et al. 2016

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“…An increased loss of marginal bone was reported by many authors, with 2-9 mm variations for a period of 3 years after implant surgery [16]. According to Tanaka [17], early failures are more frequent. In the studies, all failures occurred >1 year after implant placement.…”

Section: Discussionmentioning

confidence: 93%

Long-term implant failure in patients treated for oral cancer by external radiotherapy: a retrospective monocentric study

Desoutter

Deneuve

Condamin

et al. 2018

J Oral Med Oral Sug

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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 tissue complications but also increases the risk of osteoradionecrosis. The recent reimbursement of dental implants in oral cancer patients by the National Social Health system will probably increase the indications. Multidisciplinary staffs should be aware of benefit/risk ratio for each patient.

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Updated Clinical Considerations for Dental Implant Therapy in Irradiated Head and Neck Cancer Patients

Abstract: The article is associated with the American College of Prosthodontists' journal-based continuing education program. It is accompanied by an online continuing education activity worth 1 credit. Please visit www.wileyonlinelearning.com/jopr to complete the activity and earn credit.

Cited by 12 publications

References 59 publications

Postimplantation radiation therapy in head and neck cancer patients: Literature review

Postimplantation radiation therapy in head and neck cancer patients: Literature review

Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity‐modulated radiotherapy

Long-term implant failure in patients treated for oral cancer by external radiotherapy: a retrospective monocentric study

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