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Survival of osseointegrated implants in head and neck cancer patients submitted to multimodal treatment: a systematic review and meta-analysis

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Abstract

Purpose

To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on the consequences of the main complications, such as osteoradionecrosis and peri-implantitis.

Methods

An electronic search conducted by PRISMA protocol was performed. Full texts were carefully assessed, and data were assimilated into a tabular form for discussion and consensus among the expert panel. The quality assessment and the risk of bias are verified by Joanna Briggs Institute checklist (JBI) and The Newcastle–Ottawa Scale (NOS), and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) assessment tool.

Results

A total of 452 records were identified in the based on our PICOs strategy and after screening, 19 articles were included in the descriptive analysis of the review. Totaling 473 implants placed in irradiated and non-irradiated bone, and 31.6% of the patients were over 60 years of age. 57.9%) performed implant placement in a period of 12 months or more after the ending of radiotherapy. Only 5 studies had a follow-up period longer than 5 years after implant placement, of which three were used for the meta-analysis. In the meta-analysis of 5-year survival rate, analysis of implants in irradiated bone was assessed; a random effect model was used and a weighted proportion (PP) of 93.13% (95% CI: 87.20–99.06; p < 0.001), and in the 5-year survival rate, analysis of implants in non-irradiated bone was analysed; a fixed effect model was used and a weighted proportion (PP) of 98.52% survival (95% CI: 97.56–99.48, p < 0.001).

Conclusions

Survival rates of implants placed in irradiated bone are clinically satisfactory after a follow-up of 5 years, with a fewer percentage than in implants placed in non-irradiated bone after metanalyses performed.

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Data Availability

The authors declare that they have a file with all the data collected to carry out this review and meta-analysis.

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Authors and Affiliations

  1. Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782, Santiago de Compostela, Spain

    Gisela Cristina Vianna Camolesi

  2. Department of Stomatology, School of Dentistry, UNIFAMINAS, Muriaé, Minas Gerais, Brazil

    Henrique Rocha Mazorchi Veronese & Miriã Andrade Celestino

  3. Department of Oral and Maxillofacial Surgery, Atitus Education, Passo Fundo, Rio Grande Do Sul, Brazil

    Davi Francisco Casa Blum

  4. Department of Oral Pathology, School of Dentistry and Health Sciences, San Sebastian University, Santiago, Chile

    José Agustín Márquez-Zambrano

  5. School of Dentistry and Health Sciences, Autonomous University of Chile, Santiago, Chile

    Francisca Andrea Carmona-Pérez & Tamara Andrea Jara-Venegas

  6. Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil

    Antonio Cassio Assis Pellizzon & Wilber Edison Bernaola-Paredes

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  1. Gisela Cristina Vianna Camolesi
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Contributions

GCVC: Conceptualization, Investigation, Writing—Original Draft (results, discussion and conclusion).

HRMV: Investigation, Writing—Original Draft (material and method).

MAC: Tables 1 and 2, Fig. 1.

DFCB: Conceptualization, Investigation.

JAMZ: Conceptualization, Writing—Original Draft (introduction).

FACP: Tables 3, 4 and 5.

TAJV: Tables 3, 4 and 5.

ACAP: Conceptualization, Formal analysis.

WEBP: Conceptualization, Investigation, Review & Editing.

Corresponding author

Correspondence to Gisela Cristina Vianna Camolesi.

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Camolesi, G.C.V., Veronese, H.R.M., Celestino, M.A. et al. Survival of osseointegrated implants in head and neck cancer patients submitted to multimodal treatment: a systematic review and meta-analysis. Support Care Cancer 31, 641 (2023). https://doi.org/10.1007/s00520-023-08088-5

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