The Influence of Radiation Therapy on Dental Implantation in Head and Neck Cancer Patients
DOI:
https://doi.org/10.30683/1927-7229.2023.12.01Keywords:
Dental implants, Head and neck cancer, Radiation therapy, Irradiated patients, Implant survival, Osteoradionecrosis, Oral rehabilitationAbstract
Radiotherapy is used to treat patients with head and neck cancers as a primary therapy or as an adjuvant to surgery or chemotherapy. Irradiation results in several complications that can be very overwhelming to the patient. Frequently there is loss of function due to tooth loss, compromised aesthetics, pain and discomfort from xerostomia and mucositis, it also significantly impacts the quality of life.
A major advance in dentistry is the successful rehabilitation and replacement of lost teeth by osseointegrated implants. However, the risk of osteoradionecrosis and failure of osseointegration are barriers to implant therapy for those irradiated patients.
The aim of this review article is to primarily find out whether the radiotherapy used in the treatment of head and neck cancer patients can affect the success and survival of dental implants according to different studies, and also, to highlight some other pertinent factors that may concurrently influence these implantation.
The primary outcome measure shows implants survival in irradiated patients. Most of the studies reported that dental implants can osseointegrate and remain functionally stable in irradiated patients following oral cancer surgery. Accordingly, rehabilitation using dental implants is a viable option for head and neck cancer patients receiving radiotherapy. However, all studies included indicated that survival was significantly higher in non-irradiated patients.
Factors such as the mode of radiation therapy delivery, gender, age, implant site and radiation dose at the implant site can affect the survival of dental implant.
More research and randomized controlled trails are needed for more accurate judgment.
References
Gormley M, Creaney G, Schache A, et al. Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors. Br Dent J 2022; 233: 780-786. https://doi.org/10.1038/s41415-022-5166-x
Mody MD, Rocco JW, Yom SS, et al. Head and neck cancer. Lancet 2021; 398: 2289-2299. https://doi.org/10.1016/S0140-6736(21)01550-6
Global Cancer Observatory. International Agency for Research on Cancer. World Health Organization. Available at: https://gco.iarc.fr/ (Accessed on June 06, 2021).
Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2022. CA Cancer J Clin 2022; 72: 7-33. https://doi.org/10.3322/caac.21708
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA: A Cancer Journal for Clinicians 2021; 71(1): 7-33. https://doi.org/10.3322/caac.21654
Gandini S, Botteri E, Iodice S, et al. Tobacco smoking and cancer: a meta-analysis. International Journal of Cancer 2008; 122(1): 155-164. https://doi.org/10.1002/ijc.23033
Dhull AK, Atri R, Dhankhar R, Chauhan AK, Kaushal V. Major Risk Factors in Head and Neck Cancer: A Retrospective Analysis of 12-Year Experiences. World J Oncol 2018; 9(3): 80-84. https://doi.org/10.14740/wjon1104w
Mehanna H, Beech T, Nicholson T, et al. Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer—Systematic review and meta-analysis of trends by time and region. Head Neck 2013; 35: 747-755. https://doi.org/10.1002/hed.22015
Sturgis EM, Cinciripini PM. Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer 2007; 110(7): 1429-35. https://doi.org/10.1002/cncr.22963
Skiba-Tatarska M, Kusa-Podkańska M, Surtel A, Wysokińska-Miszczuk J. The side-effects of head and neck tumors radiotherapy. Pol Merkur Lekarski 2016; 41(241): 47-49.
Yeh SA. Radiotherapy for head and neck cancer. Semin Plast Surg 2010; 24(2): 127-36. https://doi.org/10.1055/s-0030-1255330
Ragin CC, Modugno F, Gollin SM. The epidemiology and risk factors of head and neck cancer: a focus on human papillomavirus. J Dent Res 2007; 86: 104-14. https://doi.org/10.1177/154405910708600202
Brook I. Late side effects of radiation treatment for head and neck cancer. Radiat Oncol J 2020; 38(2): 84-92. https://doi.org/10.3857/roj.2020.00213
Fischer-Brandies E. Das Risiko enossaler Implantationen nach Radiatio [Risks with endosseous implantation following radiation]. Quintessenz 1990; 41(5): 873-7.
Laurito D, Lamazza L, Spink MJ, De Biase A. Tissue-supported dental implant prosthesis (overdenture): the search for the ideal protocol. A literature review. Ann Stomatol (Roma) 2012; 3(1): 2-10.
Mancha de la Plata M, Gías LN, Díez PM, Muñoz-Guerra M, González-García R, Lee GY, Castrejón-Castrejón S, Rodríguez-Campo FJ. Osseointegrated implant rehabilitation of irradiated oral cancer patients. J Oral Maxillofac Surg 2012; 70(5): 1052-63. https://doi.org/10.1016/j.joms.2011.03.032
Cotic J, Jamsek J, Kuhar M, Ihan Hren N, Kansky A, Özcan M, Jevnikar P. Implant-prosthetic rehabilitation after radiation treatment in head and neck cancer patients: a case-series report of outcome. Radiol Oncol 2016; 51(1): 94-100. https://doi.org/10.1515/raon-2016-0005
Curi MM, Condezo AFB, Ribeiro KDCB, Cardoso CL. Long-term success of dental implants in patients with head and neck cancer after radiation therapy. Int J Oral Maxillofac Surg 2018; 47(6): 783-788. https://doi.org/10.1016/j.ijom.2018.01.012
Ettl T, Weindler J, Gosau M, Müller S, Hautmann M, Zeman F, Koller M, Papavasileiou D, Bürgers R, Driemel O, Schneider I, Klingelhöffer C, Meier J, Wahlmann U, Reichert TE. 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. J Craniomaxillofac Surg 2016; 44(9): 1453-62. https://doi.org/10.1016/j.jcms.2016.07.016
Lee J, Lee JJB, Cha IH, Park KR, Lee CG. Risk factor analysis of dental implants in patients with irradiated head and neck cancer. Head Neck 2022; 44(8): 1816-1824. https://doi.org/10.1002/hed.27080
Pompa G, Saccucci M, Di Carlo G. et al. Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study. BMC Oral Health 2015; 15: 5. https://doi.org/10.1186/1472-6831-15-5
Korfage A, Raghoebar GM, Slater JJ, Roodenburg JL, Witjes MJ, Vissink A, Reintsema H. Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years. Br J Oral Maxillofac Surg 2014; 52(9): 798-805. Erratum in: Br J Oral Maxillofac Surg 2015; 53(4): e23-5. https://doi.org/10.1016/j.bjoms.2015.01.017
Barrowman RA, Wilson PR, Wiesenfeld D. Oral rehabilitation with dental implants after cancer treatment. Aust Dent J 2011; 56(2): 160-5. https://doi.org/10.1111/j.1834-7819.2011.01318.x
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