Journal
CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY
Volume 29, Issue 2, Pages 126-137Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOO.0000000000000685
Keywords
dental implants; head and neck cancer; immediate implant placement; mandible; radiotherapy
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The review discusses the challenges of oral rehabilitation with dental implants in head and neck cancer patients, emphasizing the potential benefits of immediate implant placement before radiotherapy. The study found a slightly higher survival rate for immediately placed implants compared to delayed placement, and significantly better survival for implants not exposed to radiotherapy. The study recommends guidelines for immediate dental implant placement in the edentulous mandible in HNC patients to standardize treatment protocols and facilitate outcome comparisons.
Purpose of review Oral rehabilitation with dental implants in head and neck cancer (HNC) patients is challenging. After tooth removal prior to radiotherapy, immediate placement of dental implants during panendoscopy or surgery is thought to reduce the oral rehabilitation time improving patients' quality of life. Recent findings There is lack of consensus on the timing of dental implant placement and loading protocols. The aim of this study was to perform a systematic review of the literature regarding the performance and survival rate of immediately inserted dental implants placed prior to radiotherapy. Of 1003 articles, 10 were finally included comparing immediate vs. delayed placement of implants and comparing the effect of radiotherapy on immediately placed implants. Meta-analysis demonstrated a slightly higher survival of immediately placed implants compared with postponed placed implants [risk ratio: 0.92, 95% confidence interval (95% CI): 0.48-1.78, P = 0.81, I-2 = 0%]. The other meta-analysis comparing radiotherapy vs. nonradiotherapy showed a clearly better survival of immediately placed implants not having received radiotherapy (risk ratio: 5.02, 95% CI: 0.92-27.38, P = 0.10, I-2 = 56%). Guidelines are recommended for immediate dental implant placement in the edentulous mandible in HNC patients prior to radiotherapy to allow homogeneity regarding the treatment protocols and thus comparison of treatment outcomes.
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