Survival Rate of Implants Placed in Irradiated Maxilla and Mandible in Head and Neck Cancer Patients: A Systematic Review and Meta-Analysis
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Abstract
Background: Radiotherapy has been considered a risk factor for dental implants failure because it can change the survival rate of implants. Implant survival in irradiated bone is lower than in nonirradiated bone. The recent a systematic review and meta-analysis illustrate implant survival was 97% in nonirradiated patients and 91.9% in irradiated patients. The Implant survival in irradiated maxilla and mandible in former studies were controversial.
Objective: The purpose of this systematic review and meta-analysis was to compare the survival rate of implants placed in irradiated maxilla with implants placed in irradiated mandible.
Methods: Searches were performed in PubMed, Google Scholar, and hand search. The articles published between 1993 to March 2023 was conducted. Meta-analysis was carrying out using a random effects model.
Results: The database searches identified potentially relevant articles from PubMed 112 articles, Google Scholar 545 articles and hand search 2 articles. The relevant articles after removing duplicated were 548 articles. According to the inclusion and exclusion criteria, 18 articles were selected. Implant survival rate after average follow up 5 years was 80.9% in irradiated maxilla and 92.2% in irradiated mandible. There was a significantly higher rate of implant failure in irradiated maxilla compared to irradiated mandible. The risk ratio was 2.394 (95% CI 1.306 – 4.390, p=0.005).
Conclusions: Dental implants installed in irradiated mandible have higher survival rates compared to irradiated maxilla. A strict patient selection and strict monitoring is needed to prevent complications, thereby reducing possible failure.
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