Interplay of different cancer treatments on dental implants: Retrospective analysis of a cohort

Background: Dental rehabilitation of head and neck oncology patients has always been a challenge to the clinician. The success and complications of dental implants associated with the various treatments has always been a matter of debate. Dental implant therapy have been shown to be a successful treatment modality in the rehabilitation of head and neck oncology patients. Aim/Hypothesis: The purpose of this retrospective analysis was to show the effect of various cancer treatment modalities on the clinical outcome of dental implants. Materials and Methods: A retrospective cohort of patients within a regional service were selected to assess the survival of dental implants placed post cancer treatment between 2012-2020. The primary outcome measures were implant survival, and prosthesis survival. Secondary factors recorded included types of cancer treatment received including the type and dosage of radiotherapy, the site and timing of dental implant placement as well as recording the outcomes associated with the restoration. Results: The sample consisted of 50 implants placed in head and neck cancer patients who had received post-operative radiotherapy. The average follow up time was 48 months. All of the patients were rehabilitated with a prosthesis. The majority of all the implants placed survived. Most of the patients had implants placed in bone irradiated with more than 50 Grays. Within the cohort of patients that had implant failures, oral hygiene and their previous medical history proved to be risk factors. It was noted that a major proportion of the prosthesis were over engineered to accommodate for the oral environment of these cancer rehabilitated patients. Conclusions and Clinical Implications: The results of this study show that rehabilitation with dental implants are a feasible option for head and neck cancer patients however it is a clinicians role to be aware of the limitations due to the effects of the cancer treatment itself. Further clinical trial and systematic review are needed in this direction. Keywords: Head and neck cancer, Cancer treatment, Dental implants, Dental rehabilitation, Survival