Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study

TLDR

The study aimed to evaluate survival of dental implants placed after ablative surgery in oral cancer patients treated with or without radiotherapy. Data were collected from 34 patients (144 titanium implants) treated between 2007 and 2012, with 12 receiving postoperative radiation (<50 Gy) before implant placement, and implants were placed at least 12 months after surgery. Implant survival depended on radiotherapy status, loading timing, and implant position, with delayed loading and non‑irradiated bone showing significantly higher survival (P < 0.01). Significantly better outcomes were observed when implants were not loaded until at least 6 months after placement, suggesting delayed loading improves osseointegration and stability in oral cancer patients.

Abstract

The aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy.We collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone.Implant loss was dependent on the position and location of the implants (P = 0.05-0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determining survival. We observed significantly better outcomes when the implant was not loaded until at least 6 months after placement.Although the retrospective design of this study could be affected by selection and information biases, we conclude that a delayed loading protocol will give the best chance of implant osseointegration, stability and, ultimately, effective dental rehabilitation.