How viable are titanium implants placed in irradiated jaws? A systematic review

This summary is based on the clinical review published in the Clinical Research Supplement of the Journal of Dental Research: Dental Implants Installed in Irradiated Jaws: A Systematic Review (December 2013)

L. Chambrone, J. Mandia Jr, J.A. Shibli, G.A. Romito, and M. Abrahao

Context

The success of implant-supported restorations is associated with effective osseointegration of the dental implant, the health of the peri-implant tissue, and the reestablishment of function and aesthetics. (1-3 )  Other conditions may be associated with implant failure in specific groups of patients who are systemically compromised, including those suffering from head and neck cancer.

Irradiation may play a key role in the prognosis of patients treated with dental implants. Previous studies have reported contrasting outcomes regarding implants placed in irradiated jaws. (4-11)

Purpose of the Review

The aim of this systematic review is to evaluate the survival rate of titanium implants placed in irradiated jaws with a focus on the following focused: “Does radiation therapy to the head decrease the survival rate of titanium dental implants placed in nongrafted jaws?”

Key Findings

• Implant therapy appears to be a viable treatment option for reestablishing adequate masticatory conditions and a better quality of life for patients.
• Radiotherapy was associated with higher rates of implant loss in the majority of individual studies and in the overall meta-analysis, especially for implants placed in the maxilla.
• Surface texture may be a key variable in the success of implants placed in irradiated bone, as the failure rate indicated by the limited data on textured implants was not different from the failure rate for normal cases (nonirradiated patients).

References

1. Amarante ES, Chambrone L, Lotufo RF, Lima LA (2008). Early dental plaque formation on toothbrushed titanium implants surfaces. Am J Dent 21:318-322.
2. Faggion CM Jr, Chambrone L, Listl S, Tu YK (2011). Network meta-analysis for evaluating interventions in implant dentistry: the case of peri-implantitis treatment. Clin Implant Dent Relat Res 15:576-588.
3. Mangano C, Mangano F, Shibli JA, Tettamanti L, Figliuzzi M, d’Avila S, et al. (2011). Prospective evaluation of 2,549 Morse taper connection implants: 1- to 6-year data. J Periodontol 82:52-61.
4. Granstrom G, Bergstrom K, Tjellström A, Brånemark PI (1994). A detailed study of titanium fixture implants lost in irradiated tissues. Int J Oral Maxillofac Implants 9:653-662.
5. Buddula A, Assad DA, Salinas TJ, Garces YI (2011). Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: a retrospective analysis. Indian J Dent Res 22:644-648.
6. Verdonck HW, Meijer GJ, Nieman FH, Stoll C, Riediger D, de Baat C (2008b). Quantitative computed tomography bone mineral density measurements in irradiated and nonirradiated minipig alveolar bone: an experimental study. Clin Oral Implants Res 19:465-468.
7. Verdonck HW, Meijer GJ, Laurin T, Nieman FH, Stoll C, Riediger D, et al. (2008a). Implant
8. 8.      stability during osseointegration in irradiated and non-irradiated minipig alveolar bone: an experimental study. Clin Oral Implants Res 19:201-206.
9. Brasseur M, Brogniez V, Grégoire V, Reychler H, Lengelé B, D’Hoore W, et al. (2006). Effects of irradiation on bone remodelling around mandibular implants: an experimental study in dogs. Int J Oral Maxillofac Surg 35:850-855.
10. Brogniez V, Nyssen-Behets C, Grégoire V, Reychler H, Lengelé B (2002). Implant osseointegration in the irradiated mandible: a comparative study in dogs with a microradiographic and histologic assessment. Clin Oral Implants Res 13:234-242.
11. Bolind P, Johansson CB, Johansson P, Granström G, Albrektsson T (2006). Retrieved implants from irradiated sites in humans: a histologic/histomorphometric investigation of oral and craniofacial implants. Clin Implant Dent Relat Res 8:142-150.

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