Survival of dental implants placed in autogenous bone grafts and bone flaps in head and neck oncology patients: a systematic review

Dominic P Laverty,Robert Kelly,Owen Addison

doi:10.1186/s40729-018-0131-9

Abstract

Using implants to retain prostheses as part of the oral rehabilitation of head and neck cancer patients is an increasingly common treatment modality, particularly in transported bone which is used to reconstruct defects following oncological surgical resection. The aim of this systematic review is to evaluate the survival of dental implants placed into autogenous bone grafts and flaps, in head and neck cancer patients. MEDLINE, EMBASE, CENTRAL and Science Direct databases were searched (1980-August 2017) for studies evaluating intra-oral implant placement into autogenous bone grafts and flaps in H&N cancer patients. Twenty articles were included reporting on 1905 implants placed into autogenous bone in head and neck cancer patients. Implant survival varied from 54 to 100% within the studies with 11 studies reporting implant survival of over 90%. In conclusion, intra-oral implant survival in autogenous bone grafts in head and neck oncology patients is promising, however inconsistencies in data reporting and in outcome definitions precludes formal meta-analysis.

Highlights

Rationale The use of implants to retain prostheses as part of oral and dental rehabilitation of head and neck (H&N) cancer patients is becoming an increasingly common treatment approach [1–3]
All studies were retrospective observational studies in design with the majority undertaken at single centres; for 3 studies, this was unclear (Schultes et al [15], Yerit et al [16], Linsen et al [17]). These studies were published over a range of years (1996 to 2017) and provide cumulative data on 1905 implants placed into autogenous bone grafts in H&N cancer patients with both benign and malignant tumours being reported
Implants were placed into both vascularised and nonvascularised autogenous bone grafts, with a number of donor sites being reported. (Tables 2 and 3) These implants were placed in a variety of intra-oral sites with implants placed into autogenous bone grafts within the mandible reported in eight studies and bi-maxillary placement in nine studies, and in three studies, it was unknown where the implant fixtures were placed other than that they were placed into autogenous bone grafts

Summary

Introduction

Rationale The use of implants to retain prostheses as part of oral and dental rehabilitation of head and neck (H&N) cancer patients is becoming an increasingly common treatment approach [1–3]. Patients with H&N cancer often undergo ablative surgery with or without surgical reconstruction, radiotherapy and chemotherapy [4, 6]. Both surgical and non-surgical interventions can lead to significant disability, including facial deformity, loss of hard and soft tissue, impaired speech, swallowing and mastication [7]. Patients are commonly reconstructed with either a non-vascularised bone graft or a composite free flap. A free flap is a vascularised piece of Laverty et al International Journal of Implant Dentistry (2018) 4:19 bone (pedicled), which is being increasingly used to reconstruct tumour patients

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Discussion

Conclusion