Abstract
Objective: To investigate the clinical performance of implants with chemically modified surfaces in irradiated bone in a period of five-years. Patients & Methods: 15 (6 females, 9 males, 50.2 years with a range of 38 - 60 years) patients who had been operated for oral tumors and had undergone radiotherapy were enrolled and 40 SLActive surface implants were placed (24 in the maxilla, 16 in the mandible). Implants were allowed to integrate for a period of 90 days and the stability of the implants was measured with Resonance Frequency Analyzer/Osstell? Mentor (Integration Diagnostics, Savedalen, Sweden) at implant placement, 30 days later and at the end of the 90th day. Patients follow up periods after the implant placement varied from 20 months to 60 months (mean: 45 months). Results: Two implants were lost in maxilla in healing period as a result of osseointegration failure. The survival rate was 95%. During the observation period, totally 4 implants were lost. The overall success rate was 90%. 3 of the lost implants were in maxilla and one was in mandible. The initial ISQ values of the implants differed from 20 - 71; the second values were between 24 - 71 and the last values were between 30 - 89. The implants which were lost could not show a value greater than 35. Conclusion: There was no any complication on the SLActive surface implant placed bones due to irradiation. Within the limitations of this study, it may be concluded that osseointegrated implants can be placed in irradiated bones, unless a careful patient selection and treatment planning is performed.
Highlights
Rehabilitation of patients with head and neck cancer usually involves ablative surgery, chemotherapy, radiotherapy or a combination of these modalities
Success of osseointegration of implants depends on the bone density, surgical technique and the microscopic and macroscopic morphology of the implants, the survival and the success rates are markedly reduced in irradiated fields
Most studies demonstrated that reduction of implant stability in alveolar bone at 8 weeks after implant placement was due to impaired integration that arose from lack of remodeling and reduced bone vascularity [4] [5]
Summary
Rehabilitation of patients with head and neck cancer usually involves ablative surgery, chemotherapy, radiotherapy or a combination of these modalities. Success of osseointegration of implants depends on the bone density, surgical technique and the microscopic and macroscopic morphology of the implants, the survival and the success rates are markedly reduced in irradiated fields. Such a result is explained with reduced bone vitality [2] [3]. Most studies demonstrated that reduction of implant stability in alveolar bone at 8 weeks after implant placement was due to impaired integration that arose from lack of remodeling and reduced bone vascularity [4] [5] In these cases, there is considerable interest in enhancing the quality and rate of bone formation around dental implants. This formation of new bone can be actively influenced by implant surface properties
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