Success of dental implants after head and neck radiation therapy?

Last Updated: Jun 21, 2018

Understanding the impact of radiated fields when placing implants in survivors of head and neck cancer, may assist with treatment planning with these patients. A recent study sup>1, analyzed the long-term success and factors potentially influencing the success of dental implants placed in patients with head and neck cancer who underwent radiation therapy with a minimum total dose of 50Gy during the years 1995-2010.
The authors conclude that:

Osseointegrated dental implants can be used successfully in the oral rehabilitation of patients with head and neck cancer with a history of radiation therapy. Risk factors such as sex and the mode of radiation therapy delivery can affect implant survival.Read More

Have you had any clinical experience in placing implants in patients who have undergone head and neck radiation therapy?

1.Long-term success of dental implants in patients with head and neck cancer after radiation therapy.. Int J Oral Maxillofac Surg. 2018 Jun;47(6):783-788. Curi MM et. al.

4 Comments on Success of dental implants after head and neck radiation therapy?

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Can Bayrak

06/21/2018

The possible osteonecrosis is very hard situation to handle afterwards, so I prefer not to endanger the patient with Implant surgery. (You can call me old-fashioned) i've read the paper-in-press, it also compares conventional radiotherapy to IMRT (intensive modulated radiotherapy -more focused to the tumor rather than surrounding tissues). I am not sure if this kind of treatment is popular in my country. The amount of attached keratinized gingiva is very important in Implant survival but nevertheless i prefer conventional protetic restorations.

Junaid Ahmed BDS PGCert D

06/22/2018

Just speaking from experience. 12 months ago, I placed an implant in a patient who had Gamma50 radiotherapy for throat cancer 7 seven years ago. It failed. The flap opened a week after placement, the bone around the implant necrotised away in chunks and the implant was removed with tweezers a few months later. Patient told me he was in constant pain through the entire event , yet he still wants to try again! I refused , once bitten, twice shy. The literature supports safe placement of implants 12 months after radiotherapy but I personally would not want a repeat scenario.

Sean

06/23/2018

Radiotherapy to Head and Neck is too vague. A more useful study would be - success of dental implants in irradiated jaw bone.

Ajay Kashi, DDS, PhD

06/26/2018

Key points to consider before placing implants in irradiated bone.......duration of irradiation, dosage of radiation, other co-morbidities that the patient has. Having said these there are newer generation implants that are made from zirconia (there is no conclusive literature to support its use in compromised bone but it might be worth a try). Hyperbaric oxygen therapy (i.e., oxygen dives) prior to surgery should also be strongly considered in such cases.

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