Implant survival in mandibles of irradiated oral cancer patients

Objective: The aim of this study was to analyze long‐term implant survival in the mandible after radiotherapy and radical surgery in oral cancer patients. Study design: Between 1990 and 2003, 71 patients (15 females, 56 males; average age 57.8 years, range 16–84.1 years) were treated with dental imp...

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Published in:Clinical oral implants research 2006-06, Vol.17 (3), p.337-344
Main Authors: Yerit, Kaan C., Posch, Martin, Seemann, Maximilian, Hainich, Sibylle, Dörtbudak, Orhun, Turhani, Dritan, Özyuvaci, Hakan, Watzinger, Franz, Ewers, Rolf
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Bone Transplantation
Dental Implantation, Endosseous
Dental Implants
Dental Prosthesis Design
Dental Restoration Failure
Dentistry
Dose Fractionation
Female
Follow-Up Studies
Humans
implant
Longitudinal Studies
Male
Mandible - radiation effects
Mandible - surgery
Microsurgery
Middle Aged
Mouth Neoplasms - drug therapy
Mouth Neoplasms - radiotherapy
Mouth Neoplasms - surgery
Neoadjuvant Therapy
oral cancer
radiation therapy
Reconstructive Surgical Procedures
Survival Analysis
Treatment Outcome
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Summary:Objective: The aim of this study was to analyze long‐term implant survival in the mandible after radiotherapy and radical surgery in oral cancer patients. Study design: Between 1990 and 2003, 71 patients (15 females, 56 males; average age 57.8 years, range 16–84.1 years) were treated with dental implants after radiochemotherapy and ablative surgery of oral cancer. Radiation therapy was delivered in daily fractions of 2 Gy given on 25 days (total dose of 50 Gy). Oral defects were reconstructed microsurgically with jejunal, iliac crest or radial forearm grafts. Thereafter 316 dental implants were placed in the non‐irradiated residual bone (84; 27%), irradiated residual bone (154; 49%) or grafted bone (78; 25%) at various intervals (mean interval 1.41 (±1.01) years, range 0.34–6.35 years). Results: The mean follow‐up time after implant insertion was 5.42 (±3.21) years (range 0.3–13.61 years). The overall 2‐, 3‐, 5‐, and 8‐year survival rates of all implants were 95%, 94%, 91% and 75%. Forty‐four implants were lost in 21 patients during the observation period. Irradiation of the mandibular bone showed significantly (P=0.0028) lower implant survival compared with non‐irradiated mandibular bone. The 8‐year survival rate in the non‐irradiated residual bone (two loss), irradiated residual bone (29 loss) or grafted bone (13 loss) were 95%, 72% and 54%, respectively. Time of implantation after irradiation showed no statistically significant influence. Implant brand, length or diameter or the incidence of resective surgery on the mandible and gender of patients had no statistically significant influence on implant survival. Conclusion: Radiation therapy with 50 Gy was significantly related to shorter implant survival in mandibular bone. Survival was lowest in grafted bone. Time of implant placement had no statistically significant influence on survival under the conditions of this study. Although implant survival is lower in irradiated mandibles, implants significantly facilitate prosthodontic treatment and enhance outcome of oral rehabilitation in cancer patients.
ISSN:0905-7161
1600-0501
DOI:10.1111/j.1600-0501.2005.01160.x