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Dental Implants in Medically Compromised Patients Undergoing or After Receiving Anti-Resorptive or Radiotherapy:
Christian Mertens1, Fabian Staudinger1, Maximilian Smielowski1
1Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Clinical Oral Implants Research
|September 3, 2025
Summary
Dental implants are a viable option for patients treated with antiresorptive therapy (AR) or radiotherapy (IR), with higher success rates and less bone loss observed in the AR group. Strict preventive measures are crucial for successful outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Oncology Rehabilitation
Background:
- Patients undergoing antiresorptive (AR) or head and neck radiotherapy (IR) present unique challenges for dental implant placement.
- Compromised bone quality and altered healing potential in these patient groups necessitate specific treatment protocols.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of dental implants in patients with a history of AR or IR.
- To compare implant survival rates, marginal bone loss, and the incidence of osteonecrosis between the AR and IR groups.
Main Methods:
- A retrospective study included 92 patients (369 implants) who received dental implants after AR or IR therapy.
- Strict preventive measures included antibiotic prophylaxis and submerged healing for 4 months.
- Implant survival, marginal bone loss, and osteonecrosis were assessed.
Main Results:
- Overall implant survival rates were 92% for IR and 98% for AR.
- Mean marginal bone loss was 0.57 mm for IR and -0.09 mm for AR.
- Risk factors for failure included implantation in neomandibular/maxillary sites, maxillary location, small implant diameter, smoking, and diabetes.
Conclusions:
- Dental implants can be successfully used for rehabilitation in patients with a history of AR or IR, with careful risk assessment and adherence to preventive protocols.
- Implants placed after AR therapy showed superior survival rates and reduced marginal bone loss compared to those after IR therapy.
