Two-stage implant placement technique for the management of irradiated jaws: An animal study

J Prosthet Dent. 2017 Oct;118(4):546-550. doi: 10.1016/j.prosdent.2017.01.017. Epub 2017 Mar 23.


Statement of problem: Radiotherapy results in diminished bone remodeling capacity and an elevated risk of osteoradionecrosis, which can negatively influence the survival rate of dental implants. Patients receiving radiotherapy are advised not to receive dental implants during or soon after completing their radiotherapy.

Purpose: The purpose of this animal study was to investigate a 2-stage implant placement technique designed to diminish applied trauma on irradiated bone.

Material and methods: Two groups of white New Zealand rabbits received radiotherapy in ascending doses (2, 4, 8 Gy), while a nonirradiated group served as control. Three weeks after completion of the last radiotherapy session, one of the irradiated groups and the control group received titanium dental implants bilaterally in the femur head. For the second irradiated group, an osteotomy was performed, and the surgical wound was left to heal for 2 weeks before implant placement. All animals were sacrificed 4 weeks after implant placement, and histomorphometric analysis was used to study bone-implant contact (n=14, α=.05).

Results: Statistical analysis revealed significantly higher (F=159, P<.001) bone-implant contact in the 2-stage (40.2 ±1.9) implant placement technique than in the immediately placed implants (21.2 ±2.3) in irradiated bone. Both of the groups had a significantly lower bone-to-implant contact ratio than the non-irradiated control (64.2 ±3.8).

Conclusions: Within the limitations of this animal study, the 2-stage implant placement technique could be used to reduce trauma in irradiated bone and to improve wound healing around dental implants.

MeSH terms

  • Animals
  • Dental Implantation / methods*
  • Jaw / radiation effects*
  • Male
  • Osseointegration*
  • Rabbits