Dental implant treatment in patients with cancer on high‐dose antiresorptive medication: A prospective feasibility study with 2years follow‐up

• Published in: Clinical oral implants research Vol. 35; no. 1; pp. 63 - 76
• Main Authors: Hjortholt, C O, Andersen, S W M, Jensen, S S, Kofod, T, Gotfredsen, K
• Format: Journal Article
• Language: English
• Published: Brussels Wiley Subscription Services, Inc 01-01-2024
• Subjects: Bone implants; Cancer; Dental implants; Dental prosthetics; Dentures; Feasibility studies; Jaw; Mechanical loading; Osteonecrosis; Prostheses; Quality of life; Soft tissues; Success; Surgical implants; Survival; Teeth
• ISSN: 0905-7161; 1600-0501
• DOI: 10.1111/clr.14197

ObjectivesDental implant treatment is considered contraindicated in patients with cancer on high‐dose antiresorptive medication (HDAR). The aim of this prospective, feasibility study was to evaluate implant treatment in patients with cancer on HDAR, in terms of implant survival, implant success, and oral health‐related quality of life (OHLQoL) after 2 years of loading.Materials and MethodsImplants were inserted in three groups of HDAR patients: (1) Previous tooth extraction, no medication‐related osteonecrosis of the jaw (MRONJ), (2) Previous MRONJ, now healed, (3) Existing MRONJ, planned surgical resection. Implants were placed without adjunctive bone or soft tissue augmentation. [Correction added on 01 February 2024, after first online publication: The spelling has been corrected from “argumentation” to “augmentation” in this latest version of the article.] Abutment operation was performed after ≥12 weeks. Prosthetic treatment was initiated ≥14 weeks. Survival and success rate were determined, and OHLQoL was analyzed with OHIP‐49 and QLQ‐H&N35 questionnaires. Patients were seen for 6 months, 1‐ and 2 years follow‐up.ResultsTwenty‐two patients, 39 implants, completed the implant‐based prosthetic treatment. Implant‐supported crowns and overdentures were fabricated. Thirteen patients (59%) with 23 implants (59%) completed 2 years follow‐up. Overall implant survival and success rate after 2 years of loading were 100% and 97.4%, respectively. OHLQoL for the patients increased in all groups after the treatment, a substantial increase was seen in group 3. Two patients developed MRONJ, but not related to the implant treatment.ConclusionDental implant treatment, with high survival and success rate and increased post‐treatment OHLQoL, is feasible in HDAR patients after 2 years of loading. Caution with general recommendations should be exercised.