Comparison of early telescope loading of non-submerged ITI implants in irradiated and non-irradiated oral cancer patients.
OBJECTIVE
To compare early dental implant loading in irradiated and non-irradiated oral cancer patients in order to accelerate masticatory function improvement and quality of life.


METHODS
One hundred and fourteen non-submerged interforaminal ITI implants were early loaded in 30 patients after 3 weeks in situ (telescoped overdenture). Nineteen patients received 72 implants (63%) after local irradiation; 11 non-irradiated patients received 42 implants (37%) with a 24-month follow-up.


RESULTS
At 24 month follow-up, one early failure had occurred in an irradiated patient (=99% functioning implants in situ). Peri-implant bleeding and plaque index were similarly high in both groups (40 to 68% average). The Results of other measured parameters were as follows (values for mean; irradiated; non-irradiated patients with respective standard deviations; significance of comparison): bone loss (0.9+/-0.9; 1.4+/-0.9; 0.4+/-0.5 mM; P<0.01); Periotest score (-2.7+/-2.7; -2.4+/-2.2; -3.1+/-3.3; P<0.2); gingival recession (0.6+/-0.7 mM; 0.8+/-0.9 mM; 0.4+/-0.5 mM, P<0.02); and peri-implant probing depths (3+/-1.2; 2.6+/-0.6; 3.4+/-1.7 mM; P<0.002).


CONCLUSIONS
The results suggest reliable non-submerged implantation and early loading. However, bone loss in irradiated mandibles, combined with higher average Periotest values and gingival recession in an oral environment of altered saliva quantity, quality, microflora and local scarring, requires extended follow-up.
Landes
Constantin Alexander
CA
Maxillofacial and Plastic Facial Surgery, The J.-W. Goethe, University Medical Centre, Frankfurt, Germany. c.landes@lycos.com
Kovács
Adorján Ferenc
AF
D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000532:radiotherapy*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D003774:Dental Plaque Index; D005260:Female; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000209:etiology; D008439:Maxillary Diseases / Q000209:etiology; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000532:radiotherapy*; D010512:Periodontal Index; D014086:Tooth Mobility / Q000209:etiology; D016474:Weight-Bearing
D015921:Dental Implants