Radiotherapy and the survival of dental implants: A systematic review

Tanya L Cerajewska, Bizhan Shokouhi*

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

Abstract

Background and aim: The effects of head and neck cancer treatment with adjuvant radiotherapy can be devastating for patients. There is frequently loss of function due to tooth loss, pain and discomfort from xerostomia and mucositis, and a significant psycho-social impact. Dental implants provide an effective means of rehabilitation for many; however, irradiation poses a unique set of challenges that can affect the outcome of treatment. The aim of this review is to evaluate whether radiotherapy in head and neck cancer patients affects dental implant survival and discuss the details of pertinent influencing factors. Methods: An electronic search of the Medline, Web of Science and CENTRAL databases was used to identify studies presenting survival of implants in irradiated patients, within specified inclusion and exclusion criteria. No restriction was placed on the year of publication. The primary outcome measure was implant survival. Results: A total of 7 studies involving 441 participants and 1502 implants placed into irradiated bone were included. Meta-analysis indicated significantly higher survival in the mandible compared to the maxilla (p=0.04), and those in non-irradiated cases compared to irradiated cases (p<0.001). Other factors that showed a strong association with survival were identified as radiation dose and timing of surgery. Conclusion: Implant-based rehabilitation is a viable treatment option for head and neck cancer patients who have undergone radiotherapy. Whilst the short to medium term implant survival in these cases are high, there are multiple factors that require careful consideration for a favourable outcome. Further high-quality research and randomised controlled trials are required in this field.
Original languageEnglish
Article numberhttps://doi.org/10.1016/j.bjoms.2021.09.006
JournalBritish Journal of Oral and Maxillofacial Surgery
DOIs
Publication statusAccepted/In press - 15 Sep 2021

Keywords

  • Dental implants
  • Radiotherapy

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