Long-term results of endosteal implants following radical oral cancer surgery with and without adjuvant radiation therapy

Clin Implant Dent Relat Res. 2012 Apr;14(2):250-8. doi: 10.1111/j.1708-8208.2009.00248.x. Epub 2009 Oct 16.


Purpose: The aim of this study was to analyze the long-term survival of implants and implant-retained prostheses in patients after ablative surgery of oral cancer with or without adjunctive radiation therapy.

Materials and methods: Between 1997 and 2008, 66 patients who had undergone ablative tumor surgery in the oral cavity were treated with dental implants (n = 262). Thirty-four patients received radiation therapy in daily fractions of 2 Gy administered on 18 to 30 days. Implants were inserted in the maxilla (49; 18.7%) or mandible (213; 81.3%), in non-irradiated residual (65; 24.8%) or grafted bone (44; 16.8%) and in irradiated residual (15.6%) or grafted bone (39; 14.9%). Seventeen fixed protheses and 53 removable dentures (34 bar attachments, 9 telescopic and 10 ball retained dentures) were inserted.

Results: Mean follow-up after implant insertion was 47.99 (±34.31) months (range 12-140 months). The overall 1-, 5-, and 10-year survival rates of all implants were 96.6%, 96.6%, and 86.9%, respectively. Fourteen implants were lost in nine patients (5.3% of all implants); eight implants were primary losses, and five secondary losses because of an operation of tumor recurrence. There was no significantly lower implant survival for implants inserted into irradiated bone (p = .302), bone and/or soft-tissue grafts (p = .436), and maxilla or mandible (p = .563). All prosthetic restorations in patients without tumor recurrence could be maintained during the observation period.

Conclusions: Implant survival is not significantly influenced by radiation therapy, grafts (bone and/or soft tissue), or location (maxilla or mandible). However, implants placed in irradiated bone exhibit a higher failure rate during the healing period than those placed in non-irradiated bone. No superstructure was particularly favorable. Osseointegrated implants can be used successfully in patients with prior history of ablative surgery with and without additional radiation therapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Transplantation / pathology
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Child
  • Dental Implants*
  • Dental Prosthesis Design
  • Dental Prosthesis, Implant-Supported
  • Dental Restoration Failure
  • Denture Retention
  • Denture, Overlay
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Mandible / radiation effects
  • Mandible / surgery
  • Maxilla / radiation effects
  • Maxilla / surgery
  • Middle Aged
  • Mouth Neoplasms / radiotherapy
  • Mouth Neoplasms / surgery*
  • Neoplasm Recurrence, Local / surgery
  • Osseointegration / radiation effects
  • Peri-Implantitis / etiology
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Survival Analysis
  • Young Adult


  • Dental Implants