title: Survival and complications of implants to support craniofacial prosthesis: A systematic review.
abstract: OBJECTIVE
  To assess the survival rate of craniofacial implants (CIs) to support facial prosthesis/epithesis and the prevalence of surgical/biological complications based on previously published studies.
  
  
  METHODS
  An electronic search was undertaken in March/2016. Only studies with a minimum of 5 patients were included. Untransformed proportions of implant failures for different regions were calculated. A meta-analysis evaluated the influence of radiotherapy on the failure rates. A meta-regression was performed considering the follow-up period as covariate.
  
  
  RESULTS
  Seventy publications included 2355 patients and 8184 CIs (545 failures). The probability of a failure was 5.5% for all CIs (95%CI 4.5-6.5, P < 0.001), 1.2% for CIs in the auricular region (95%CI 0.8-1.5, P < 0.001), 12.2% for the nasal region (95%CI 9.0-15.5, P = 0.017), and 12.1% for the orbital region (95%CI 9.3-15.0, P < 0.001). Radiotherapy statistically affected the CIs rates (OR 5.80, 95%CI 3.77-8.92, P < 0.00001). There was no statistically significant influence of the follow-up time on the proportion of implant failures (P = 0.814). Soft tissue adverse reactions were the most common complications.
  
  
  CONCLUSIONS
  Implants placed in the auricular region have a lower probability of failure than those in the nasal and orbital regions. Soft tissue adverse reactions were the most common complications. Radiotherapy significantly affected the CIs failure rates.
authors: Department of Prosthodontics, Faculty of Odontology (Head: Dr. A. Wennerberg, DDS, PhD), Malmö University, Carl Gustafs väg 34, SE-205 06, Malmö, Sweden. Electronic address: bruno.chrcanovic@mah.se.
authors: Bruno Ramos
authors: BR
authors: Chrcanovic
authors: Department of Oral and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark; Department of Surgical Sciences, Oral and Maxillofacial Surgery (Head: Dr. Per Hellman, MD, PhD), Uppsala University, Uppsala, Sweden. Electronic address: johanna.lisa.nilsson@gmail.com.
authors: Johanna
authors: J
authors: Nilsson
authors: Department of Surgical Sciences, Oral and Maxillofacial Surgery (Head: Dr. Per Hellman, MD, PhD), Uppsala University, Uppsala, Sweden. Electronic address: andreas.thor@akademiska.se.
authors: Andreas
authors: A
authors: Thor
mesh_terms: D005147:Facial Bones / Q000601:surgery*; D006801:Humans; D019736:Prostheses and Implants / Q000009:adverse effects* / Q000706:statistics & numerical data; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000706:statistics & numerical data
keywords: Complications; Craniofacial epithesis; Craniofacial implants; Craniofacial prosthesis; Extraoral implants; Failure rate