Long-Term Outcomes of Dental Implants in Head and Neck Cancer Survivors Following Radiotherapy

Dental implants have become a cornerstone in oral rehabilitation for head and neck cancer survivors. However, radiotherapy-integral to cancer treatment-can compromise bone quality, potentially affecting implant survival.

A retrospective survey was conducted among 80 head and neck cancer survivors who received dental implants post-radiotherapy between 2010 and 2020 at two tertiary care centers. A structured questionnaire and follow-up clinical evaluation assessed implant survival, peri-implant conditions, and patient satisfaction. Key variables included radiation dose (>50 Gy or <50 Gy), time between radiotherapy and implant placement, and the use of adjunctive hyperbaric oxygen therapy (HBOT). Implant survival was defined as functional, pain-free implants without mobility or peri-implant radiolucency after a minimum 3-year follow-up.

Out of 250 dental implants placed in 80 irradiated patients, 212 implants (84.8%) survived beyond 5 years. Patients who received radiation doses <50 Gy showed a higher survival rate (91.2%) compared to those with >50 Gy (78.5%). The survival rate was significantly better in patients who waited more than 12 months before implant placement (90.5%) versus those with < 6 months interval (75.3%) (P < 0.05). The use of HBOT showed a modest but statistically insignificant improvement in survival (86.7% with HBOT vs. 83.5% without). The most common complications included peri-implant mucositis (16.2%) and peri-implantitis (8.1%).

Dental implants can provide favorable long-term outcomes in irradiated head and neck cancer patients, especially when radiation doses are moderate and implant placement is delayed post-therapy.