Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years

We aimed to assess oral functioning, patients' satisfaction, condition of peri-implant tissues, and survival of implants up to 14 years after their insertion in patients with oral cancer who had had mandibular overdentures placed over primary implants. Endosseous dental implants were inserted prospectively in the interforaminal region of the mandible during resection of the tumour in 164/180 patients with oral cancer. All 58 patients were evaluated by questionnaires and clinical assessments during a final assessment in 2012. Implant-retained mandibular overdentures were inserted, and prosthetic rehabilitation and oral functioning were not associated with primary site or stage of the tumour, number or type of implants inserted, or the type of reconstruction. Over time the peri-implant mucosa was usually free of inflammation. More implants were lost in patients treated by radiotherapy (27/318, 8.5%) than in those not so treated (1/206, 0.5%). Patients who had been treated by irradiation reported more problems in oral functioning and less satisfaction than those who had not. Patients with an implant-retained mandibular overdenture reported fewer problems in oral functioning than patients without an overdenture. Primary insertion of an implant should be routinely incorporated in the surgical planning for patients with oral cancer, as oral functioning in those wearing mandibular overdentures improved considerably and peri-implant health was at least reasonable.