Implant-supported oral rehabilitation in oncology patients: a retrospective cohort study


      Oral rehabilitation after treatment for head and neck cancer can be challenging. Implant-supported rehabilitation can considerably improve oral health-related quality of life, but there is a dearth of contemporary evidence of reported outcomes and trends in this cohort. In this study we retrospectively investigated the outcomes of 115 patients (376 dental implants) with a mean (range) follow up of 3.91(0.11-12.76) years. We considered survival of the implants, percentage of those used for prosthetic rehabilitation, time from diagnosis to placement and restoration, additional operations involving soft-tissue revision, and the effects of radiotherapy, chemotherapy, and reconstructive flaps on these outcomes. Implant survival was 97%. A total of 32% of patients had radiotherapy with a mean dose of 61 Gy. A total of 94% of cases were restored with all the implants placed. Computed coefficients from a multinomial logistic regression model suggested that a trend towards radiotherapy, implant placement in the graft, and placement in the maxilla had a negative influence on success, but this was not significant (p > 0.05). The placement of implants in a reconstructive flap was strongly associated with the need for soft tissue revision. The approach used (placement during primary cancer resection or after) significantly influenced the time to placement and restoration (p = 0.016). These data suggest a local trend towards earlier placement of implants (during primary cancer resection) resulting in earlier restorative rehabilitation. Outcome data show that the survival of implants is comparable to that in non-oncological cases, and that radiotherapy and location of the implant have less influence on implant survival than previous studies have suggested.


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        • Jemal A.
        • Bray F.
        • Center M.M.
        • et al.
        Global cancer statistics.
        CA Cancer J Clin. 2011; 61: 69-90
        • Schepers R.H.
        • Slagter A.P.
        • Kaanders J.H.
        • et al.
        Effect of postoperative radiotherapy on the functional result of implants placed during ablative surgery for oral cancer.
        Int J Oral Maxillofac Surg. 2006; 35: 803-808
        • Dholam K.P.
        • Gurav S.V.
        Dental implants in irradiated jaws: a literature review.
        J Cancer Res Ther. 2012; : S85-93
        • Doll C.
        • Nack C.
        • Raguse J.D.
        • et al.
        Survival analysis of dental implants and implant-retained prostheses in oral cancer patients up to 20 years.
        Clin Oral Investig. 2015; 19: 1347-1352
        • Chrcanovic B.R.
        • Albrektsson T.
        • Wennerberg A.
        Dental implants in irradiated versus nonirradiated patients: a meta-analysis.
        Head Neck. 2016; 38: 448-481
        • Laverty D.P.
        • Addison O.
        • Wubie B.A.
        • et al.
        Outcomes of implant-based oral rehabilitation in head and neck oncology patients—a retrospective evaluation of a large, single regional service cohort.
        Int J Implant Dent. 2019; 5: 8
        • Butterworth C.
        • McCaul L.
        • Barclay C.
        Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines.
        J Laryngol Otol. 2016; 130: S41-4
        • Wijbenga J.G.
        • Schepers R.H.
        • Werker P.M.
        • et al.
        A systematic review of functional outcome and quality of life following reconstruction of maxillofacial defects using vascularized free fibula flaps and dental rehabilitation reveals poor data quality.
        J Plast Reconstr Aesthet Surg. 2016; 69: 1024-1036
        • Garrett N.
        • Roumanas E.D.
        • Blackwell K.E.
        • et al.
        Efficacy of conventional and implant-supported mandibular resection prostheses: study overview and treatment outcomes.
        J Prosthet Dent. 2006; 96: 13-24
        • Kwakman J.M.
        • Freihofer H.P.
        • van Waas M.A.
        Osseointegrated oral implants in head and neck cancer patients.
        Laryngoscope. 1997; 107: 519-522
        • Granström G.
        Osseointegration in irradiated cancer patients: an analysis with respect to implant failures.
        J Oral Maxillofac Surg. 2005; 63: 579-585
        • Elledge R.
        • Chaggar J.
        • Knapp N.
        • et al.
        Craniofacial implants at a single centre 2005-2015: retrospective review of 451 implants.
        Br J Oral Maxillofac Surg. 2017; 55: 242-245
        • Chambrone L.
        • Mandia Jr, J.
        • Shibli J.A.
        • et al.
        Dental implants installed in irradiated jaws: a systematic review.
        J Dent Res. 2013; 92 (119S-30S)
        • Smolka K.
        • Kraehenbuehl M.
        • Eggensperger N.
        • et al.
        Fibula free flap reconstruction of the mandible in cancer patients: evaluation of a combined surgical and prosthodontic treatment concept.
        Oral Oncol. 2008; 44: 571-581
        • Butterworth C.J.
        • Rogers S.N.
        The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy.
        Int J Implant Dent. 2017; 3: 37