The Influence of Radiation Therapy on Dental Implantation in Head and Neck Cancer Patients

Abstract

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.