International Journal of Prosthodontics and Restorative Dentistry

Register      Login

VOLUME 12 , ISSUE 4 ( October-December, 2022 ) > List of Articles


Survival Rates of Dental Implants in Irradiated Patients with Extraoral Maxillofacial Prosthesis: A Systematic Review

Darshana Shah, Chirag Chauhan, Maitri Mehta, Kanisha Shah, Raj Shukla

Keywords : Craniofacial prosthesis, Dental implants, Extraoral craniofacial prosthesis, Implant-supported extraoral maxillofacial prosthesis

Citation Information : Shah D, Chauhan C, Mehta M, Shah K, Shukla R. Survival Rates of Dental Implants in Irradiated Patients with Extraoral Maxillofacial Prosthesis: A Systematic Review. Int J Prosthodont Restor Dent 2022; 12 (4):198-205.

DOI: 10.5005/jp-journals-10019-1393

License: CC BY-NC 4.0

Published Online: 03-05-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Purpose: To evaluate the effect of the location of implants, radiation therapy, and soft tissue reactions on survival rates of dental implants in the extraoral maxillofacial prosthesis. Materials and methods: An electronic search was conducted for articles published in English, listed with Medline (PubMed) and Embase from 2000 to till date. The focused question was “Is there any effect of location, radiation, and soft tissue reactions on survival rates of dental implants in extraoral maxillofacial prosthesis?” The selection of articles was done according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guidelines. The risk of bias was checked using the Newcastle–Ottawa scale. Results: The investigation identified a total of 10,800 titles of studies with extraoral maxillofacial prostheses, out of which 17 studies were included in this review based on the selection criteria. It was seen that there was an increase in the failure rate of dental implants in the extraoral maxillofacial prosthesis in presence of radiation. The mean survival rate of implants in nonirradiated areas was 82.6% whereas that of irradiated areas was 77.72%, suggesting a lower survival rate in irradiated areas. Conclusion: Radiation therapy does affect the survival rates of implants, but they are not a contraindication. Implant placement in such cases must be calculated and planned carefully, with special emphasis on the quality of bone, location of implants and their characteristics, compliance, and manual abilities of the patients, and their health status.

PDF Share
  1. Leonardi A, Buonaccorsi S, Pellacchia V, et al. Maxillofacial prosthetic rehabilitation using extraoral implants. J Craniofac Surg 2008;19(2):398–405. DOI: 10.1097/SCS.0b013e318163e443
  2. Nadeau J. Special prostheses. J Prosthet Dent 1968;20(1):62–76. DOI: 10.1016/0022-3913(68)90213-8
  3. Allen PF, Watson G, Stassen L, et al. Peri-implant soft tissue maintenance in patients with craniofacial implant retained prostheses. Int J Oral Maxillofac Surg 2000;29(2):99–103. PMID: 10833145.
  4. Schoen PJ, Raghoebar GM, van Oort RP, et al. Treatment outcome of bone-anchored craniofacial prostheses after tumor surgery. Cancer 2001;92(12):3045–3050. DOI: 10.1002/1097-0142(20011215)92:12<3045::aid-cncr10147>;2-k
  5. Abu-Serriah MM, McGowan DA, Moos KF, et al. Outcome of extra-oral craniofacial endosseous implants. Br J Oral Maxillofac Surg 2001,39:269–275. DOI: 10.1054/bjom.2000.0578
  6. Scolozzi P, Jaques B. Treatment of midfacial defects using prostheses supported by ITI dental implants. Plas Reconstr Surg 2004;114(6):1395–1404. DOI: 10.1097/01.prs.0000138595.86570.3e
  7. Toljanic JA, Eckert SE, Roumanas E, et al. Osseointegrated craniofacial implants in the rehabilitation of orbital defects: an update of a retrospective experience in the United States. J Prosthet Dent 2005;94(2):177–182. DOI: 10.1016/j.prosdent.2005.04.016
  8. Karakoca S, Aydin C, Yilmaz H, et al. Survival rates and periimplant soft tissue evaluation of extraoral implants over a mean follow-up period of three years. J Prosthet Dent 2008;100(6):458–464. DOI: 10.1016/S0022-3913(08)60265-6
  9. Karayazgan-Saracoglu B, Zulfikar H, Atay A, et al. Treatment outcome of extraoral implants in the craniofacial region. J Craniofac Surg 2010;21(3):751–758. DOI: 10.1097/SCS.0b013e3181d8413a
  10. Pekkan G, Tuna SH, Oghan F. Extraoral prostheses using extraoral implants. J Oral Maxillofac Surg 2011;40(4):378–383. DOI: 10.1016/j.ijom.2010.12.001
  11. Ethunandan M, Downie I, Flood T. Implant-retained nasal prosthesis for reconstruction of large rhinectomy defects: the Salisbury experience. Int J Oral Maxillofac Surg 2010;39(4):343–349. DOI: 10.1016/j.ijom.2010.01.003
  12. Karakoca Nemli S, Aydin C, Yilmaz H, et al. Retrospective study of implant-retained orbital prostheses: implant survival and patient satisfaction. J Craniofac Surg 2010;21(4):1178–1183. DOI: 10.1097/SCS.0b013e3181e2083a
  13. Benscoter BJ, Jaber JJ, Kircher ML, et al. Osseointegrated implant applications in cosmetic and functional skull base rehabilitation. Skull Base 2011;21(5):303–308. DOI: 10.1055/s-0031-1284211
  14. Curi MM, Oliveira MF, Molina G, et al. Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation. J Oral Maxillofac Surg 2012;70(7):1551–1557. DOI: 10.1016/j.joms.2012.03.011
  15. Oliveira JA, Abrahao M, Dib LL. Extraoral implants in irradiated patients. Braz J Otorhinolaryngol 2013;79(2):185–189. DOI: 10.5935/1808-8694.20130033
  16. de Mello MC, Guedes R Jr, de Oliveira JA, et al. Extraoral implants for orbit rehabilitation: a comparison between one-stage and two-stage surgeries. Int J Oral Maxillofac Surg 2014;43(3):341–347. DOI: 10.1016/j.ijom.2013.09.002
  17. Mueller S, Hohlweg-Majert B, Buergers R, et al. The functional and aesthetic reconstruction of midfacial and orbital defects by combining free flap transfer and craniofacial prosthesis. Clin Oral Investig 2015;19(2):413–419. DOI: 10.1007/s00784-014-1243-0
  18. Korfage A, Raghoebar GM, Noorda WD, et al. Recommendations for implant-retained nasal prostheses after ablative tumor surgery: minimal surgical aftercare, high implant survival, and satisfied patients. Head Neck 2016;38(1):619–624. DOI: 10.1002/hed.24053
  19. Balik A, Ozdemir-Karatas M, Peker K, et al. Soft Tissue Response and Survival of Extraoral Implants: A Long-Term Follow-up. J Oral Implantol 2016;42(1):41–45. DOI: 10.1563/aaid-joi-D-14-00086
  20. Subramaniam SS, Breik O, Cadd B, et al. Long-term outcomes of craniofacial implants for the restoration of facial defects. Int J Oral Maxillofac Surg 2018;47(6):773–782. DOI: 10.1016/j.ijom.2018.01.013
  21. Roumanas E, Nishimura RD, Beumer J, et al. Craniofacial Defects and Osseointegrated Implants: Six-Year Follow-up Report on the Success Rates of Craniofacial Implants at UCLA. Int J Oral Maxillofac Implants 1994;9(5):579–586.
  22. Wolfaardt JF, Wilkes GH, Parel SM, et al. Craniofacial osseointegration: the Canadian experience. Int J Oral Maxillofac Implants 1993;8(2):197–204. PMID: 8359877.
  23. Parel SM, Tjellström A. The United States and Swedish experience with osseointegration and facial prostheses. Int J Oral Maxillofac Implants 1991;6(1):75–79. PMID: 1843497.
  24. Albrektsson T, Brånemark PI, Jacobsson M, et al. Present clinical applications of osseointegrated percutaneous implants. Plast Reconstr Surg 1987;79(5):721–730. DOI: 10.1097/00006534-198705000-00007
  25. Granstrom G, Bergstrom K, Tjellstrom A, et al. A detailed analysis of titanium implants lost in irradiated tissues. Int J Oral Maxillofac Implants 1994;9(6):653–662. PMID: 1398819.
  26. Jacobsson M, Tjellstrom A, Fine L, et al. A retrospective study of osseointegrated skin-penetrating titanium fixtures used for retaining facial prostheses. Int J Oral Maxillofac Implants 1992;7(4):523–528. PMID: 1299649.
  27. Nishimura RD, Roumanas E, Moy PK, et al. Osseointegrated implants and orbital defects: U.C.L.A. experience. J Prosthet Dent 1998;79(3):304–309. DOI: 10.1016/s0022-3913(98)70242-2
  28. Jacobsson M, Tjellstrom A, Thomsen P, et al. Integration of titanium implants in irradiated bone. Histologic and clinical study. Ann Otol Rhinol Laryngol 1988;97(4 Pt 1):337–340. DOI: 10.1177/000348948809700402
  29. ElKhashab MA, Radi IAW, Elkhadem AH. Implant prognosis in irradiated versus non-irradiated nasal, orbital and auricular sites. Int J Oral Maxillofac Surg 2020;49(5):636–648. DOI: 10.1016/j.ijom.2019.09.010
  30. Visser A, Raghoebar GM, van Oort RP, et al. Fate of implant-retained craniofacial prostheses: life span and aftercare. Int J Oral Maxillofac Implants 2008;23(1):89–98. PMID: 18416416.
  31. Shokouhi, B, Cerajewska T. Radiotherapy and the survival of dental implants: a systematic review. Br J Oral Maxillofac Surg 2022;60(4):422–429. DOI: 10.1016/j.bjoms.2021.09.006
  32. Alberga J, Eggels I, Visser A, et al. Outcome of implants placed to retain craniofacial prostheses - a retrospective cohort study with a follow-up of up to 30 years. Clin Implant Dent Relat Res 2022;24(5):643–654. DOI: 10.1111/cid.13106
  33. Holgers KM, Tjellstrom A, Bjursten LM, et al. Soft tissue reactions around percutaneous implants: a clinical study on skin-penetrating titanium implants used for bone-anchored auricular prostheses. Int J Oral Maxillofac Implants 1987;2(1):35–39. PMID: 3471713.
  34. Vitomir KS, Filip I, Vojkan L, et al. Survival rate of disk and screw-type implants used for the retention of extraoral prostheses. J Prosthet Dent 2022;127(3):499–507. DOI: 10.1016/j.prosdent.2020.07.023
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.