Impact of radiotherapy on implant-based prosthetic rehabilitation in patients with head and neck cancer: A prospective observational study on implant survival and quality of life─Preliminary results

• Published in: Journal of cranio-maxillo-facial surgery Vol. 44; no. 9; pp. 1453 - 1462
• Main Authors: Ettl, Tobias, Priv.-Doz. Dr. Dr, Weindler, Janet, DDS, Gosau, Martin, MD, DDS, PhD, Müller, Steffen, MD, DDS, Hautmann, Matthias, MD, Zeman, Florian, PhD, Koller, Michael, PhD, Papavasileiou, Dimitrios, DDS, Bürgers, Ralf, DDS, PhD, Driemel, Oliver, MD, DDS, PhD, Schneider, Isabel, DDS, Klingelhöffer, Christoph, MD, DDS, Meier, Johannes, MD, DDS, Wahlmann, Ulrich, MD, DDS, PhD, Reichert, Torsten E., MD, DDS, PhD
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.09.2016
• Subjects: Aged; Aged, 80 and over; Dentistry; Female; Head and neck cancer; Head and Neck Neoplasms - radiotherapy; Head and Neck Neoplasms - surgery; Humans; Implant success; Male; Middle Aged; Mouth, Edentulous - rehabilitation; Prospective Studies; Prostheses and Implants; Prosthesis Failure; Prosthetic rehabilitation; Quality of Life; Radiotherapy; Risk Factors; Smoking - adverse effects; Surgery; Surveys and Questionnaires; Treatment Outcome; Xerostomia - complications; prosthetic rehabilitation; radiotherapy; head and neck cancer; quality of life; implant success; Head and neck cancer; Implant success; Prosthetic rehabilitation; Radiotherapy; Quality of life
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2016.07.016

Summary Purpose To study implant-based prosthetic rehabilitation of head and neck cancer patients with focus on implant survival and quality of life. Materials and Methods The prospective observational study presents preliminary results of 29 edentulous head neck cancer patients (20 patients after radiotherapy) with 165 OsseoSpeed implants. Implant success after 1-year follow-up was evaluated by means of the Albrektsson criteria. Quality of life was analysed with the EORTC QLQ-C30, QLQ-H&N35, and OHIP 14 questionnaires. Results The overall implant survival rate after 1 year was 95.2% (157/165). Implant success measured by the Albrektsson criteria showed a lower success rate of 86.7% (143/165), mainly because of peri-implant marginal bone loss with a mean of 0.8 mm after 1 year. Xerostomia (p=0.008), implant insertion within the radiation target volume (p=0.09), implantation in transplanted bone (p=0.05), and smoking (p=0.041) were the main reasons for implant failure, followed by D4 bone quality, maxillary implant site, and insufficient primary stability. Speaking, swallowing, eating, as well as social integration and individual self-confidence had considerably improved 1 year after denture placement compared to before treatment. Conclusion Implant-based prosthetic rehabilitation of head and neck cancer patients is possible at a calculable risk and significantly improves patients' quality of life.