title: Craniofacial implants at a single centre 2005-2015: retrospective review of 451 implants.
abstract: Craniofacial endosseous implants are regularly used to support prostheses in the rehabilitation of complex defects, but reported success rates vary. To review our own clinical practice over 10 years, and particularly to examine the impact of radiotherapy and the timing of placement on the survival of implants, we retrospectively audited the records for all patients who had endosseous implants for prosthetic rehabilitation in our unit between 2005 and 2015. We reviewed 167 records, which gave 451 implants, of which, 222 (49%) were auricular, 98 (22%) nasal, and 131 (29%) orbital. Most were placed after ablative operations for cutaneous malignancy (n=103 patients, 62%). The failure rate of implants placed in bone that was irradiated either before or after placement was significantly higher than that of those placed in non-irradiated bone (univariate analysis: 11% compared with 2%, p<0.001: Kaplan-Meier survival analysis: p<0.001). The timing of placement in relation to radiotherapy (before compared with after) seemed to have no impact on success (p=0.96). Our findings are in keeping with previous reports, and the principal observation is that radiotherapy adversely affects success. We work closely with our maxillofacial prosthetists and place implants at the time of ablation. Our findings seem to support this practice regardless of whether or not the patient will later require adjuvant radiotherapy.
authors.affiliation: Oral and Maxillofacial Surgery, University Hospitals Birmingham NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland. Electronic address: rosselledge@doctors.net.uk.
authors.forename: R
authors.initials: R
authors.lastname: Elledge
authors.affiliation: Oral and Maxillofacial Surgery, University Hospitals Birmingham NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland. Electronic address: Jas_chaggar@live.com.
authors.forename: J
authors.initials: J
authors.lastname: Chaggar
authors.affiliation: Oral and Maxillofacial Surgery, University Hospitals Birmingham NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland. Electronic address: Nakita.Knapp@uhb.nhs.uk.
authors.forename: N
authors.initials: N
authors.lastname: Knapp
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland. Electronic address: timothy.martin@uhb.nhs.uk.
authors.forename: T
authors.initials: T
authors.lastname: Martin
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland; NHS England Skin Cancer Clinical Reference Group, University Hospitals Birmingham NHS Foundation Trust. Electronic address: Nicholas.White@uhb.nhs.uk.
authors.forename: N
authors.initials: N
authors.lastname: White
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland. Electronic address: Demetrius.Evriviades@uhb.nhs.uk.
authors.forename: D
authors.initials: D
authors.lastname: Evriviades
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland. Electronic address: stefan.edmondson@uhb.nhs.uk.
authors.forename: S
authors.initials: S
authors.lastname: Edmondson
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH West Midland. Electronic address: sat.parmar@uhb.nhs.uk.
authors.forename: S
authors.initials: S
authors.lastname: Parmar
mesh_terms: D005147:Facial Bones / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008447:Maxillofacial Prosthesis; D019931:Maxillofacial Prosthesis Implantation; D008875:Middle Aged; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery; D013997:Time Factors
keywords: Craniofacial implants; Maxillofacial prosthetics