There is debate among clinicians regarding the placement of implants in patients who have undergone radiation therapy for cancer. A retrospective study by Granstrom evaluated the survival of 631 osseointegrated implants placed in irradiated cancer patients over a 25-year period. The files of 107 patients were evaluated and compared with a control group of nonirradiated patients. The study found that implant failures were higher after previous radiation therapy when compared to the control group, with especially high failure rates after high-dose radiation therapy and a long time after irradiation. The highest implant failures were seen in the frontal bone, zygoma, mandible, and nasal maxilla; the lowest implant failures were in the oral maxilla. Implant failure decreased with the use of long implants, fixed retention, and adjuvant hyperbaric oxygen therapy. In spite of these findings, however, the author states that the high rate of survival after cancer therapy, and the favorable outcomes of osseointegrated implant therapy, means that implant placement in the irradiated patient can be recommended. The clinician must be aware of the risks involved when treating these patients. Thorough preoperative planning with a team of specialists is recommended, and the author recommends that oral rehabilitation of irradiated patients should be performed at clinics and institutions that are experienced in treating cancer patients.
(Source: Journal of Oral and Maxillofacial Surgery, Vol. 63, No. 5, 2005).
