Outcomes of implant-based oral rehabilitation in head and neck oncology patients\u2014a retrospective evaluation of a large, single regional service cohort

Dominic P Laverty,Sat Parmar,Giseon Heo,Berhanu A Wubie,Timothy Martin,Owen Addison,Prav Praveen,David Pearson,Geoffrey Bateman,David Newsum,Michael Murphy

doi:10.1186/s40729-019-0161-y

Abstract

BackgroundThe study reports on implant survival outcomes in head and neck cancer patients who received implant-based oral rehabilitation in a regional service centre.MethodsA retrospective analysis of implant survival outcomes in patients treated in a regional service from 2012 to 2017 was performed. The primary outcome measure was implant survival. The secondary outcome measure was to assess the effect of covariates associated with implant failure including bone type, radiotherapy, chemotherapy, gender and surgical implant complications. Kaplan-Meier survival curves were applied to compare differences in the survival rates of groups of variables. Cox proportional hazards models were applied to identify covariates associated with implant failure. p value was set at 0.05.ResultsThe sample was composed of 167 head and neck cancer patients who had 779 dental implants placed. Implant survival estimates were calculated: 3 years, 95.7% [95%CI 94.3–97.2%] and 5 years, 95.5% [95%CI 93.9–97.0%], with a median follow-up of 38 months. Gender (p = 0.09), radiotherapy (p = 0.16) and chemotherapy (p = 0.17) did not significantly influence implant survival, whereas implant failure was higher in transported (reconstructed) bone sites in comparison with native bone (p < 0.01).ConclusionThe result of this study suggests that overall implant survival as part of the routine oral rehabilitation is high in this patient cohort; however, implant failure was found to be statistically higher for implant placed into transported bone in comparison to native bone.

Highlights

The study reports on implant survival outcomes in head and neck cancer patients who received implant-based oral rehabilitation in a regional service centre
Oral rehabilitation with implant-retained prostheses can significantly improve the quality of life (QoL) for patients following the surgical management of head and neck (H&N) cancer [1], and this treatment modality is becoming more commonly used in this patient group [2,3,4]
Study design and setting The service evaluation was performed by retrospectively examining treatment records of H&N oncology patients who were provided with an implant-retained prosthesis as part of an oral and dental rehabilitation

Summary

Introduction

The study reports on implant survival outcomes in head and neck cancer patients who received implant-based oral rehabilitation in a regional service centre. Oral rehabilitation with implant-retained prostheses can significantly improve the quality of life (QoL) for patients following the surgical management of head and neck (H&N) cancer [1], and this treatment modality is becoming more commonly used in this patient group [2,3,4]. Rehabilitation with a removable prosthesis can often be difficult, if not impossible in Laverty et al International Journal of Implant Dentistry (2019) 5:8 some patients following surgical management of their H&N oncology. This is due to altered post-surgical anatomy, low salivary flow and a lack of emotional resilience of the patient [6]. The use of osseointegrated dental implants has allowed improved retention of removable prostheses, reduced loading on vulnerable tissues and with this resulted in a reported improvement in the QoL for patients [2, 7, 13, 14]

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