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Dental implants installed in irradiated jaws: a systematic review
L Chambrone1, J Mandia, J A Shibli
1Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
Journal of Dental Research
|October 26, 2013
Summary
Dental implants in irradiated jaws show a higher failure risk, especially in the maxilla. Hyperbaric oxygen therapy did not improve implant survival rates in these patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomaterials Science
- Oncology
Background:
- Head and neck radiotherapy significantly impacts bone healing and osseointegration.
- Titanium dental implants are crucial for restoring function in irradiated patients.
- Limited data exists on implant survival rates in irradiated bone sites.
Purpose of the Study:
- To evaluate the survival rate of titanium implants placed in irradiated jaws.
- To compare implant survival between irradiated and non-irradiated patients.
- To assess the efficacy of hyperbaric oxygen (HBO) therapy on implant survival in irradiated patients.
Main Methods:
- Systematic literature search of MEDLINE, EMBASE, and CENTRAL databases.
- Inclusion of studies on titanium implants in non-grafted irradiated jaw sites.
- Random effects meta-analyses to determine risk ratios for implant failure.
Main Results:
- A significant increase in implant failure risk was observed in irradiated patients (RR: 2.74) and maxillary sites (RR: 5.96).
- Mean implant survival rates varied widely (46.3% to 98.0%) across included studies.
- Hyperbaric oxygen therapy did not demonstrate a significant reduction in implant failure risk (RR: 1.28).
Conclusions:
- Implant therapy is a viable option for restoring occlusion and mastication in irradiated patients, despite increased failure risks.
- Maxillary implants face a substantially higher failure rate post-radiotherapy.
- Further research is needed, particularly on HBO therapy's role and implants in non-machined surfaces.
