Osseointegrated implants in irradiated bone: a case-controlled study using adjunctive hyperbaric oxygen therapy

J Oral Maxillofac Surg. 1999 May;57(5):493-9. doi: 10.1016/s0278-2391(99)90059-9.


Purpose: The current investigation was undertaken to study whether osseointegration of implants in irradiated tissues is subject to a higher failure rate than in nonirradiated tissues. It further aimed to study whether hyperbaric oxygen treatment (HBO) can be used to reduce implant failure.

Patients and methods: Seventy-eight cancer patients who were rehabilitated using osseointegrated implants between 1981 and 1997 were investigated. Three groups of patients were compared: irradiated (A), nonirradiated (B), and irradiated and HBO-treated (C). In addition, 10 irradiated patients who had lost most of their implants received new ones after HBO treatment. These were compared as a case-control group.

Results: Implant failures were highest in group A (53.7%). Implant failure was 13.5% in group B and 8.1% in group C. The difference between group A and the other two groups was statistically significant (P = .001 to .0023, Mantell's test). HBO significantly improved implant survival in the case-control group from 34 of 43 implants lost to 5 of 42 lost (P = .0078).

Conclusions: Implant insertion in irradiated bone is associated with a higher failure rate. Adjuvant HBO treatment can reduce the failures.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cobalt Radioisotopes / therapeutic use
  • Dental Implantation, Endosseous
  • Dental Restoration Failure
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / rehabilitation
  • Head and Neck Neoplasms / surgery
  • Humans
  • Hyperbaric Oxygenation*
  • Male
  • Middle Aged
  • Nose / surgery
  • Orbit / surgery
  • Orthognathic Surgical Procedures
  • Osseointegration*
  • Prostheses and Implants*
  • Prosthesis Failure
  • Radiopharmaceuticals / therapeutic use
  • Radiotherapy Dosage
  • Skull / radiation effects
  • Skull / surgery*
  • Temporal Bone / surgery
  • Treatment Outcome


  • Cobalt Radioisotopes
  • Radiopharmaceuticals