Titanium osseointegrated implants combined with hyperbaric oxygen therapy in previously irradiated mandibles.
BACKGROUND
Treatment for head and neck malignancies commonly involves radiation therapy. As a result of this therapy the vascular supply to irradiated structures is altered and results in decreased tissue perfusion. In addition to vascular changes, bony structures undergo a reduction in osteoblastic and osteoclastic activity. These tissue alterations, especially in the mandible, enhance the risk of osteoradionecrosis. To avoid this occurrence, many patients who have undergone radiation therapy do not receive elective preprosthetic surgeries, including implant therapy. PURPOSE OF STUDY AND METHODS: This report presents the preliminary results of placing 18 titanium screw implants into previously irradiated mandibles in conjunction with hyperbaric oxygen therapy.


RESULTS
Of the 18 implants placed, 17 (94%) were judged to be osseointegrated at the abutment connection. One implant did not receive an abutment and was "put to sleep." The remaining 16 (88%) were used for prosthetic rehabilitation.


CONCLUSIONS
The use of implants in irradiated tissues may provide a means of enhancing prosthetic rehabilitation while reducing the risk of tissue trauma that may develop into osteoradionecrosis.
Arcuri
M R
MR
Department of Hospital Dentistry, University of Iowa Hospital and Clinics, Iowa City, USA.
Fridrich
K L
KL
Funk
G F
GF
Tabor
M W
MW
LaVelle
W E
WE
D000293:Adolescent; D000368:Aged; D016723:Bone Remodeling / Q000528:radiation effects; D016371:Cranial Irradiation / Q000009:adverse effects*; D003758:Dental Implantation, Endosseous; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008334:Mandible / Q000098:blood supply / Q000528:radiation effects* / Q000601:surgery; D008336:Mandibular Diseases / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D016348:Osseointegration / Q000528:radiation effects; D010025:Osteoradionecrosis / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium