title: Implant-prosthetic rehabilitation after radiation treatment in head and neck cancer patients: a case-series report of outcome.
abstract: BACKGROUND
  Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy.
  
  
  METHODS
  Twenty irradiated head and neck cancer patients who received a removable implant-supported denture at the University Medical Centre Ljubljana were included in the study. Kaplan-Meier survival analysis, Cox proportional hazard models and logistic regression were used to assess the implant survival and success rate.
  
  
  RESULTS
  Twenty patients had 100 implants inserted. The estimated implant survival rate was 96% after 1 year and 87% after 5 years. Failures were mostly observed before loading (91.2%). Implants inserted in the transplanted bone were significantly more likely to fail. Out of 89 implants supporting the dentures, 79 implants (88.7%) were successful, meaning that they were functionally loaded and exhibited no pain, radiolucency or progressive bone loss. Prosthetic treatment was significantly less successful in older patients. The attachment system and the number of implants did not have a statistically significant influence on the success rate.
  
  
  CONCLUSIONS
  Implant-supported dentures have been shown to be a reliable treatment modality after head and neck cancer surgery and radiation therapy. Possible early failures should be communicated with the patients.
authors.affiliation: Department of Prosthodontics, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Jasna
authors.initials: J
authors.lastname: Cotic
authors.affiliation: Department of Prosthodontics, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Jure
authors.initials: J
authors.lastname: Jamsek
authors.affiliation: Department of Prosthodontics, Faculty of Medicine, University of Ljubljana, Slovenia; Department of Prosthodontics, University Medical Centre Ljubljana, Slovenia.
authors.forename: Milan
authors.initials: M
authors.lastname: Kuhar
authors.affiliation: Department of Maxillofacial and Oral Surgery, Faculty of Medicine, University of Ljubljana, Slovenia; Department of Maxillofacial and Oral Surgery, University Medical Centre Ljubljana, Slovenia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Ihan Hren
authors.affiliation: Department of Maxillofacial and Oral Surgery, Faculty of Medicine, University of Ljubljana, Slovenia; Department of Maxillofacial and Oral Surgery, University Medical Centre Ljubljana, Slovenia.
authors.forename: Andrej
authors.initials: A
authors.lastname: Kansky
authors.affiliation: University of Zürich, Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Switzerland.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Özcan
authors.affiliation: Department of Prosthodontics, Faculty of Medicine, University of Ljubljana, Slovenia; Department of Prosthodontics, University Medical Centre Ljubljana, Slovenia.
authors.forename: Peter
authors.initials: P
authors.lastname: Jevnikar
keywords: dental implants; head and neck cancer; implant-supported dentures; radiation therapy