Implant survival in mandibles of irradiated oral cancer patients

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Implant survival in mandibles of irradiated oral cancer patients
Issue online:
02 Mar 2006
Date:
Accepted 24 November 2004
To cite this article: Kaan C Yerit, Martin Posch, Maximilian Seemann, Sibylle Hainich, Orhun Dàrtbudak, Dritan Turhani, Hakan ˜zyuvaci, Franz Watzinger, Rolf Ewers (2006)
Implant survival in mandibles of irradiated oral cancer patients
Clinical Oral Implants Research 17 (3), 337Ò344.
doi:10.1111/j.1600-0501.2005.01160.x
Blackwell Synergy

Kaan C. Yerit11University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Wien, Austria, Martin Posch22Department of Medical Statistics, University of Vienna, Wien, Austria, Maximilian Seemann11University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Wien, Austria, Sibylle Hainich33Department of Conservative Dentistry, Clinic of Dentistry, Medical University of Vienna, Wien, Austria, Orhun Dàrtbudak44Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland, Dritan Turhani11University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Wien, Austria, Hakan ˜zyuvaci55Department of Oral Surgery, Faculty of Dentistry, Istanbul University, Turkey, Franz Watzinger11University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Wien, Austria and Rolf Ewers11University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Wien, Austria

Correspondence to:
Dr Dr Kaan C. Yerit
University Hospital of Cranio-Maxillofacial and Oral Surgery
Medical University of Vienna
Waehringer Guertel 18-20
A-1090 Wien
Austria
Tel.: +43 1 40400 4252
e-mail: kaan.yerit@univie.ac.at

Abstract

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 16Ò84.1 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 0.34Ò6.35 years).

Results: The mean follow-up time after implant insertion was 5.42 (±3.21) years (range 0.3Ò13.61 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.

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