Radiotherapy: a contraindication for dental implants?

Radiotherapy has been considered a contraindication for dental implants. However, many clinicians have installed implants in irradiated patients with some success.
A recent systemic review review of the literature compared the success rate of implants placed in irradiated human bone tissue with that of implants placed in nonirradiated areas.
The conclusion:

Dental implants installed in the irradiated area of an oral cavity have a high survival rate, but strict monitoring is needed to prevent complications, thereby reducing possible failures.

What have you done in your practice when faced with a patient undergoing radiotherapy? Implants or not?

Read the Full Abstract Here

1. J Prosthet Dent. 2016 Dec;116(6):858-866 Irradiated patients and survival rate of dental implants: A systematic review and meta-analysis. Smith Nobrega A, et al.

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One thought on “Radiotherapy: a contraindication for dental implants?

  1. “Dental implants installed in the irradiated area of an oral cavity have a high survival rate, but strict monitoring is needed to prevent complications”
    I submit that monitoring for complications will do nothing to prevent complications, as osteoradionecrosis can’t be prevented once the prevailing conditions (i.e., prior radiation and oral surgery) are in place. Granted, a patient with radiation-induced xerostomia will have his problems with a removable prosthesis, but I suspect the prospect of osteoradionecrosis would be a deal breaker if the implant surgeon fully informs him of this risk. The devil is in the details, and the potential for ORN is radiation-dose dependent; most risk begins at 30 Gy, and becomes more significant at 60 Gy.

    I commend you to a recent article in OOOO:
    Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):28-34. doi: 10.1016/j.oooo.2016.01.007. Epub 2016 Jan 14.
    Osteoradionecrosis following treatment for head and neck cancer and the effect of radiotherapy dosimetry: the Guy’s and St Thomas’ Head and Neck Cancer Unit experience.
    https://www.ncbi.nlm.nih.gov/pubmed/27039003

    Notwithstanding this systematic review, a clinician who initiates ONJ and attempts to shield himself with a claim that he is “strictly monitoring” his patient would be standing on shaky legal ground in a court of law.

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