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Endosteal implants in the irradiated lower jaw
F Watzinger1, R Ewers, A Henninger
1University Clinic for Maxillofacial Surgery, University of Vienna, Austria.
Summary
Dental implants in irradiated jaws show varying success rates. Implants in local bone had the highest survival, while those in bone grafts had the lowest, indicating graft viability is crucial for implant success.
Area of Science:
- Oral Surgery
- Dental Implantology
- Oncology
Background:
- Endosteal implants have been used for dental rehabilitation in patients with irradiated lower jaws since 1990.
- Squamous cell carcinomas (T2-T4 stage) necessitate complex reconstructive procedures.
Purpose of the Study:
- To evaluate the survival rates of IMZ implants placed in different mandibular reconstruction scenarios following cancer treatment.
- To compare implant survival, bone loss, and infection rates across various graft and tissue conditions.
Main Methods:
- A retrospective study involving 26 patients with squamous cell carcinomas treated with IMZ implants.
- Implants were placed in three groups: local bone/soft tissue, local bone with soft tissue graft, and bone/soft tissue graft.
- Kaplan-Meier survival analysis was used to assess 3-year implant survival rates.
Main Results:
- Three-year implant survival rates were 87.8% (Group 1), 69.1% (Group 2), and 58.3% (Group 3).
- No significant differences in marginal bone loss or infection were observed between groups (P > 0.29).
- A mandibular fracture due to postradiation-osteonecrosis occurred in Group 2; graft failures were noted in Group 3.
Conclusions:
- Implant survival is significantly influenced by the type of reconstruction, with local bone offering better outcomes than bone grafts.
- Graft viability and integration are critical factors for the long-term success of endosteal implants in irradiated mandibles.
- Further research is needed to optimize implant placement in complex grafted sites.