Risk factors for periimplantitis and implant loss in orbital implants

After orbital exenteration a facial prosthesis is a viable option for rehabilitation. The aim of this study was to evaluate implant loss and peri-implantitis of solitary orbital implants with regard to risk factors.

Implant loss (primary outcome) and periimplantitis (secondary outcome) were reviewed retrospectively in patients who received orbital implants between 2006 and 2015 with a minimum follow-up time of 12 months. Potential risk factors were analyzed using univariate and multivariate statistics.

94 patients were included with 371 inserted implants and 326 implants remaining for final analysis. At the time of last follow-up 18.1% (59/326) of the implants were lost and 3.4% showed signs of periimplantitis but were still stable in situ. Daily smoking (p = 0.016, OR = 2.1), irradiation (p < 0.001, OR = 2.8) and daily alcohol abuse (p = 0.028, OR = 3.1) had a significant effect on periimplantitis and implant loss. Combining smoking and irradiation, implant failure was 46.9% versus 15.0% in patients without these risk factors (p < 0.001, OR = 5.0). Age, tumor entity, ASA Score, anticoagulation, chemotherapy, diabetes and implant position did not show a significant correlation for implant loss or - except for age - periimplantitis. Younger patients showed a higher risk of developing periimplantitis (p = 0.011).

Orbital prostheses retained by solitary implants provide a solid option to reconstruct facial defects. Whereas in general high implant survival can be expected, they should be carefully considered in patients with the risk factors irradiation, smoking and alcohol abuse.