Retrospective Study of Implant-Retained Orbital Prostheses: Implant Survival and Patient Satisfaction

Purpose: Extraoral implants provide the prostheses excellent stability and retention. However, the use of implants in the orbit showed questionable survival rates. Furthermore, evaluation of this treatment from the patients' point of view is lacking in clinical studies. The purpose of this study was to evaluate outcomes of implant-retained prosthetic treatment of orbital defects in implant survival, peri-implant soft tissue health, and patients' satisfaction. Materials and Methods: Extraoral implants were placed in the orbital defects. After a 3- to 6-month osseointegration period, prostheses were fabricated. Recall examinations were performed 1 week and 3 and 6 months after prosthesis insertion, subsequently, every 6 months. Implant survival was estimated using the Kaplan-Meier method. A 5-point scale was used to record tissue health. A questionnaire was applied to obtain the patients' perceptions of prosthesis after insertion and at 1-year recall. Results: A total of 36 patients (17 men and 19 women) with 109 implants were evaluated. Mean age was 44.8 (18.3) years. The overall cumulative survival rate was 69.4%; 75% for nonirradiated patients and 62.5% for irradiated patients. Three months after prostheses insertion, no skin reaction was observed in 12 patients, grade 1 and 2 reactions was observed in 16 patients, and granulation was observed in 7 patients. In 2 years, grade 2 and 3 reactions decreased. Slight incensement was observed in skin reactions after the second year. Patients' satisfaction on appearance decreased after 1 year. A statistically significant increase was found in comfort, retention, ease of use, and self-confidence (P < 0.05). The long-term predictability of orbital implants is still questionable. Therefore, orbital implants should be used in patients who understand complications, and meticulous hygiene is required. Although complications are relatively frequent in the orbit, implant-retained prostheses enhance the patients' quality of life, providing self-confidence.