Osseointegrated implants in irradiated bone: a case-controlled study using adjunctive hyperbaric oxygen therapy.
OBJECTIVE
The current investigation was undertaken to study whether osseointegration of implants in irradiated tissues is subject to a higher failure rate than in nonirradiated tissues. It further aimed to study whether hyperbaric oxygen treatment (HBO) can be used to reduce implant failure.


METHODS
Seventy-eight cancer patients who were rehabilitated using osseointegrated implants between 1981 and 1997 were investigated. Three groups of patients were compared: irradiated (A), nonirradiated (B), and irradiated and HBO-treated (C). In addition, 10 irradiated patients who had lost most of their implants received new ones after HBO treatment. These were compared as a case-control group.


RESULTS
Implant failures were highest in group A (53.7%). Implant failure was 13.5% in group B and 8.1% in group C. The difference between group A and the other two groups was statistically significant (P = .001 to .0023, Mantell's test). HBO significantly improved implant survival in the case-control group from 34 of 43 implants lost to 5 of 42 lost (P = .0078).


CONCLUSIONS
Implant insertion in irradiated bone is associated with a higher failure rate. Adjuvant HBO treatment can reduce the failures.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000601:surgery; D009915:Orbit / Q000601:surgery; D056948:Orthognathic Surgical Procedures; D016348:Osseointegration; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D012886:Skull / Q000528:radiation effects / Q000601:surgery*; D013701:Temporal Bone / Q000601:surgery; D016896:Treatment Outcome