title: Implant-based rehabilitation in oncology patients can be performed with high long-term success.
abstract: OBJECTIVE
  Radiotherapy and compromised vital bone and/or surrounding soft tissue can be a challenge to the successful osseointegration of dental implants. We evaluated the long-term results of dental implants in patients with oral cancer.
  
  
  METHODS
  To address the research purpose, we designed and implemented a retrospective cohort study that included patients with oral cancer who had received dental implants from 2003 to 2011. The data were collected from a clinical oncology database. The predictor variables included a set of heterogeneous variables grouped into logical sets of demographics, surgical treatment, dental rehabilitation, radiotherapy type, and tumor entity. The primary outcome variable was implant survival; the secondary outcome variable was peri-implantitis. The descriptive statistics, survival time analysis, Kaplan-Meier implant survival curves, and Cox hazard proportional modeling were computed.
  
  
  RESULTS
  The study sample included 59 patients with oral cancer (20 women [33.9%], 39 men [66.1%]; mean age at tumor diagnosis, 55 years), who had had 272 implants placed during the study period. The mean follow-up period was 30.9 months (range 3 to 82). Of the 272 implants, 269 (98.9%) and 264 (97.1%) had survived for 2 and 5 years, respectively. During the observation period, 10 implants were lost (3.7%). Of the implant failures, 82% occurred in transplanted bone (4 fibula flaps, 4 iliac crests, and 2 native mandibles). We observed peri-implantitis caused by insufficiently attached gingiva and bone loss in 182 of the implants (67%). The factors associated with implant failure were peri-implantitis, insufficient soft and hard tissue, muscle dysfunction, and xerostomia.
  
  
  CONCLUSIONS
  Implant-based rehabilitation in oncology patients can achieve a high long-term success rate, although risk factors such as impaired muscle function and a high frequency of peri-implantitis can affect healing.
authors.affiliation: Intern, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. Electronic address: Sarah.hessling@uk-erlangen.de.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Hessling
authors.affiliation: Assistant Medical Director, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Wehrhan
authors.affiliation: Medical Specialist, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Schmitt
authors.affiliation: Intern, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Manuel
authors.initials: M
authors.lastname: Weber
authors.affiliation: Medical Specialist, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Tilo
authors.initials: T
authors.lastname: Schlittenbauer
authors.affiliation: Head, Department for Oral and Craniomaxillofacial and Facial Plastic Surgery, Johannes Wesling Clinic Minden, Minden, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Scheer
mesh_terms: D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000503:physiopathology / Q000628:therapy*; D016348:Osseointegration; D016016:Proportional Hazards Models; D016896:Treatment Outcome