title: An Adverse Implication of Radiation Therapy for Implant-Retained Maxillofacial Prostheses.
abstract: We report the 19-year postoperative course of a patient whose maxillary defect was reconstructed with maxillofacial implant-retained facial prostheses. The patient received 60 Gy of radiation therapy. Adjunctive hyperbaric oxygen therapy was administered and four 4.0-mm long maxillofacial implants were inserted. Four years and 6 months after insertion surgery, two of the four implants were lost and the others showed bone regression in the surrounding bone. All implants were replaced with Epitec System maxillofacial implants placed in non-irradiated bone. Eleven years and 6 months after replacement, the Epitec System has been maintaining good and firm osseointegration. Appropriate selection of implant sites and no history of radiation therapy are keys to successful implant reconstruction. However, adjunctive hyperbaric oxygen therapy is believed to be effective, osseointegrated implant should be inserted at a point appropriately distant from an irradiated lesion.
authors.affiliation: Department of Plastic Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. akamatu@is.icc.u-tokai.ac.jp.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Akamatsu
authors.forename: Ushio
authors.initials: U
authors.lastname: Hanai
authors.forename: Megumi
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kuroki
authors.forename: Yotaro
authors.initials: Y
authors.lastname: Tsunoda
authors.forename: Muneo
authors.initials: M
authors.lastname: Miyasaka
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008437:Maxilla / Q000601:surgery; D008441:Maxillary Neoplasms / Q000601:surgery*; D008447:Maxillofacial Prosthesis; D019931:Maxillofacial Prosthesis Implantation / Q000379:methods*; D009915:Orbit / Q000601:surgery; D016348:Osseointegration; D011475:Prosthesis Failure; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome