title: Osseointegrated implant rehabilitation of irradiated oral cancer patients.
abstract: OBJECTIVE
  The aim of this study is to analyze implant survival in patients who received radiotherapy treatment for oral malignancies and in patients who had suffered mandibular osteoradionecrosis.
  
  
  METHODS
  We reviewed retrospectively 225 implants placed in 30 patients who had received radiotherapy as part of the oncologic treatment. Radiation doses ranged between 50 and 70 Gy. 39 implants were placed after a combined treatment of radiotherapy and chemotherapy. Data referred to tumour type and reconstruction, presence of osteoradionecrosis, region of implant installation and type of prostheses were recorded. Survival rates were calculated with cumulative Kaplan-Meier survival curves and compared between different groups with a log-rank test.
  
  
  RESULTS
  152 osseointegrated implants were placed in patients who presented previous reconstruction procedure. Five patients developed osteorradionecrosis as a complication of the radiotherapy treatment. Once osteoradionecrosis had healed in these patients, 41 implants were installed. The overall 5 year survival rate in irradiated patients was 92.6%. Irradiated patients had a marginally significantly higher implant loss than non-irradiated patients. (p = 0.063). The 5 year survival rate in the osteoradionecrosis group was of 48.3% and in the non-osteoradionecrosis group 92.3%, with a statistically significant difference between both groups. (p = 0.002).
  
  
  CONCLUSIONS
  Osseointegrated implants enhance oral rehabilitation in most irradiated patients, even being an acceptable option for patients who had suffered osteoradionecrosis. Totally implant supported prostheses are recommended after irradiation providing functional, stable and aesthetically satisfactory rehabilitation.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Montepríncipe, Grupo Madrid, Madrid, Spain. maria.mancha@yahoo.es
authors.forename: Maria
authors.initials: M
authors.lastname: Mancha de la Plata
authors.forename: Luis Naval
authors.initials: LN
authors.lastname: Gías
authors.forename: Pedro Martos
authors.initials: PM
authors.lastname: Díez
authors.forename: Mario
authors.initials: M
authors.lastname: Muñoz-Guerra
authors.forename: Raul
authors.initials: R
authors.lastname: González-García
authors.forename: Gui-Youn Cho
authors.initials: GY
authors.lastname: Lee
authors.forename: Sergio
authors.initials: S
authors.lastname: Castrejón-Castrejón
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Rodríguez-Campo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D059186:Chemoradiotherapy, Adjuvant; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported / Q000145:classification; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000209:etiology; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000532:radiotherapy*; D020360:Neoadjuvant Therapy; D056948:Orthognathic Surgical Procedures; D016348:Osseointegration / Q000502:physiology*; D010025:Osteoradionecrosis / Q000209:etiology; D011879:Radiotherapy Dosage; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015921:Dental Implants