Effect of post-implantation radiation therapy on dental implant osseointegration in oral cancer patients: a systematic review of literature
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20240020Keywords:
Dental implant, Osseointegration, Post-implantation RT, Radiotherapy, Oral cancerAbstract
Dental implant placement for functional rehabilitation after oral cancer surgery could be done either before or after radiation therapy (RT). In both of the above scenarios, radiation exposure could affect implant osseointegration and survival. The present review aimed to evaluate the effect of post-implantation RT on osseointegration of dental implants placed in patients treated for oral cancer. A literature search was conducted to identify studies published in English between 2001 and November 2023. Articles reporting about the success of dental implant osseointegration after post-implantation radiotherapy were selected. Data about overall success of osseointegration and with respect to the anatomic site (maxilla, mandible or grafted bone), radiation dose and time-interval between implant placement and radiation exposure were collected and analyzed. Out of 189 articles identified through literature search, 12 studies fulfilling the inclusion criteria were systematically reviewed. In 403 patients, 1333 dental implants were placed prior to RT, out of which 1223 successfully osseointegrated (91.75%). The implant osseointegration rates in maxilla, mandible and grafted bone were 92.06% (255/277), 95.14% (313/329) and 80% (60/75), respectively. There was no relationship between radiation dose or time-interval and success of implant osseointegration. Based on the present review, it may be concluded that dental implants placed at least 1.5-3 months prior to RT, would successfully osseointegrate without major complications. The native maxilla and mandible are a favored choice for implant placement before radiotherapy, than grafted bone.
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References
Nooh N. Dental implant survival in irradiated oral cancer patients: a systematic review of the literature. Int J Oral Maxillofacial Implants. 2013;28(5):1233-42.
Goker F, Beretta P, Baj A, Bolzoni AR, Maiorana C, Beltramini G et al. Oral rehabilitation of oncology patients with dental implants after reconstruction surgery with autogenous flaps. Euro Rev Med Pharmacological Sci. 2022;26(3):51-61.
Alkindi M, Ramalingam S, Alghamdi O, Alomran OM, Binsalah MA, Badwelan M. Guided bone regeneration with osteoconductive grafts and PDGF: A tissue engineering option for segmental bone defect reconstruction. J Applied Biomaterials Functional Materials. 2021;19:2280800020987405.
Badwelan M, Alkindi M, Alghamdi O, Ahmed A, Ramalingam S, Alrahlah A. Bone Regeneration Using PEVAV/β-Tricalcium Phosphate Composite Scaffolds in Standardized Calvarial Defects: Micro-Computed Tomographic Experiment in Rats. Materials (Basel, Switzerland). 2021;14(9).
Moiduddin K, Mian SH, Elseufy SM, Alkhalefah H, Ramalingam S, Sayeed A. Polyether-Ether-Ketone (PEEK) and Its 3D-Printed Quantitate Assessment in Cranial Reconstruction. J Functional Biomaterials. 2023;14(8).
Wiedenmann F, Liebermann A, Probst F, Matthias T, Panagiotis B, Matthias G et al. A pattern of care analysis: Prosthetic rehabilitation of head and neck cancer patients after radiotherapy. Clin Implant Dentistr Rel Res. 2020;22(3):333-41.
Alberga JM, Vissink A, Korfage A, Sebastiaan AHJ, Max JHW, Johannes AL et al. Site-specific radiation dosage and implant survival in oral cancer patients: A cohort study. Oral dis. 2023.
Ernst N, Sachse C, Raguse JD, Stromberger C, Nelson K, Nahles S. Changes in Peri-Implant Bone Level and Effect of Potential Influential Factors on Dental Implants in Irradiated and Nonirradiated Patients Following Multimodal Therapy Due to Head and Neck Cancer: A Retrospective Study. J Oral Maxillofacial Surg. 2016;74(10):1965-73.
Koudougou C, Bertin H, Lecaplain B, Zahi B, Julie L, Pierre C et al. Postimplantation radiation therapy in head and neck cancer patients: Literature review. Head Neck. 2020;42(4):794-802.
Atanásio Pitorro TE, de Araújo Reis NT, Paranhos LR, Ferreira Soares PB. Survival of Dental Implants Placed Pre-Radiotherapy Versus Post-Radiotherapy in Native Bone: A Systematic Review. Int J Oral Maxillofac Implants. 2022;37(6):1100-9.
Schoen PJ, Raghoebar GM, Vissink A, Roodenburg JL. Mandibulotomy and implant insertion. Head Neck. 2003;25(9):748-53.
Iizuka T, Häfliger J, Seto I, Rahal A, Mericske-Stern R, Smolka K. Oral rehabilitation after mandibular reconstruction using an osteocutaneous fibula free flap with endosseous implants. Factors affecting the functional outcome in patients with oral cancer. Clin Oral Impl Res. 2005;16(1):69-79.
Schepers RH, Slagter AP, Kaanders JH, van den Hoogen FJ, Merkx MA. Effect of postoperative radiotherapy on the functional result of implants placed during ablative surgery for oral cancer. Int J Oral Maxillofac Surg. 2006;35(9):803-8.
Cuesta-Gil M, Ochandiano Caicoya S, Riba-García F, Duarte Ruiz B, Navarro Cuéllar C, Navarro Vila C. Oral rehabilitation with osseointegrated implants in oncologic patients. J Oral Maxillofac Surg. 2009;67(11):2485-96.
Korfage A, Schoen PJ, Raghoebar GM, Roodenburg JL, Vissink A, Reintsema H. Benefits of dental implants installed during ablative tumour surgery in oral cancer patients: a prospective 5-year clinical trial. Clin Oral Impl Res. 2010;21(9):971-9.
Fenlon MR, Lyons A, Farrell S, Bavisha K, Banerjee A, Palmer RM. Factors affecting survival and usefulness of implants placed in vascularized free composite grafts used in post-head and neck cancer reconstruction. Clin Impl Dentistr Rel Res. 2012;14(2):266-72.
Mizbah K, Dings JP, Kaanders JH, Van den Hoogen FJH, Koole R, Meijer GJ et al. Interforaminal implant placement in oral cancer patients: during ablative surgery or delayed? A 5-year retrospective study. Int J Oral Maxillofac Surg. 2013;42(5):651-5.
Korfage A, Raghoebar GM, Slater JJ, Roodenburg JNL, Witjes MJH, Vissink A et al. Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years. Bri J Oral Maxillofac Surg. 2014;52(9):798-805.
Ettl T, Junold N, Zeman F, Matthias H, Sebastian H, Carola K et al. Implant survival or implant success? Evaluation of implant-based prosthetic rehabilitation in head and neck cancer patients-a prospective observational study. Clin Oral Investigations. 2020;24(9):3039-47.
Sandoval ML, Rosen EB, Robert AJ, Nelson JA, Matros E, Gelblum DY. Immediate dental implants in fibula free flaps to reconstruct the mandible: A pilot study of the short-term effects on radiotherapy for patients with head and neck cancer. Clin Implant Dentistr Relat Res. 2020;22(1):91-5.
Li J, Feng K, Ye L, Liu Y, Sun Y, Wu Y. Influence of radiotherapy on dental implants placed in individuals before diagnosed with head and neck cancer: focus on implant-bed-specific radiation dosage. Clin Oral Investigat. 2022;26(9):5915-22.
Schiegnitz E, Reinicke K, Sagheb K, König J, Al-Nawas B, Grötz KA. Dental implants in patients with head and neck cancer-A systematic review and meta-analysis of the influence of radiotherapy on implant survival. Clin Oral Implants Res. 2022;33(10):967-99.
Shugaa-Addin B, Al-Shamiri HM, Al-Maweri S, Tarakji B. The effect of radiotherapy on survival of dental implants in head and neck cancer patients. J Clin Experimental Dentistr. 2016;8(2):e194-200.
Al-Bazie SA, Bahatheq M, Al-Ghazi M, Al-Rajhi N, Ramalingam S. Antibiotic protocol for the prevention of osteoradionecrosis following dental extractions in irradiated head and neck cancer patients: A 10 years prospective study. J Cancer Res Therapeut. 2016;12(2):565-70.
