Osseointegrated implant-based dental rehabilitation in head and neck reconstruction patients

Background. Dental restoration is an integral part of head and neck cancer reconstruction. Methods. We evaluated the success rate of osseointegrated implants in patients with head and neck cancer, comparing outcomes between implants placed in fibula free flaps to those placed in native mandibular and maxillary bone. Results. A total of 1132 implants were placed in 246 patients. The overall implant loss rate was 3.7% and was higher in fibula flaps (8.2%) compared to the native mandible (2.6%) and maxilla (2.2%), although these differences did not reach statistical significance (p = .059 and p = .053, respectively). The failure rate was 8.0% for implants placed after radiation and 3.6% in patients who did not undergo radiation (p = .097). Osteoradionecrosis (ORN) occurred in 19 patients (7.7%) after implant placement, and tobacco use was found to be a risk factor (p = .027). Conclusion. Osseointegrated implants are reliable in patients with head and neck cancer, including those undergoing bony free flap reconstruction. (C) 2015 Wiley Periodicals, Inc.