Survival of dental implants and occurrence of mucosal overgrowth in patients with head and neck cancer treated with/without radiotherapy and mucosal graft - two-year follow-up

Q: What were the study’s primary and secondary aims?

The primary aim was to compare treatment modalities for dental implant survival in head and neck cancer patients. The secondary aim was to evaluate how often mucosal overgrowth occurred around implants after treatment with or without mucosal grafts.

Q: How many patients and implants were included, and what was the overall DI survival rate?

The study involved 59 patients and 196 implants. The overall DI survival rate was 88% over the observational period (mean follow-up 2 years 10 months).

Q: Did radiotherapy significantly affect implant survival, and where was mucosal overgrowth most common?

Implant survival was not significantly influenced by radiotherapy during the observational period. Mucosal overgrowth was more common in mucosal grafted areas, with 36 of the 42 overgrowth cases occurring in grafted regions.

Sep 21, 2026

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Objectives: Compare head and neck cancer treatment modalities (surgery alone vs surgery with radiotherapy or chemoradiotherapy) for dental implant (DI) survival, and assess the prevalence of mucosal overgrowth around DI with or without mucosal grafts. Methods: Retrospective observational cohort of 59 patients with malignant head and neck tumors receiving DI between 2015 and 2019; outcomes were retrieved from hospital records. Radiation dose was quantified using sum of 3D dose distributions. Results: Overall DI survival was 88%, with no significant modality effect; mucosal overgrowth occurred in 21% of implants, mainly in grafted areas.

LanguageEnglish

CategoryResearch & Report

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Pages8

Reading Time20 min

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Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Introduction

Materials and methods

Clinical Oral Investigations (2024) 28:117 [https://doi.org/10.1007/s00784-023-05479-0](https://doi.org/10.1007/s00784-023-05479-0) Survival of dental implants and occurrence of mucosal overgrowth in patients with head and neck cancer treated with/without radiotherapy and mucosal graft—two‑year follow‑up Viivi Mattila1 · Tommy Wilkman1 · Nina‑Li Avellán1 · Karri Mesimäki1 · Jussi Furuholm1 · Hellevi Ruokonen1 · Karita Nylund1 Received: 13 June 2023 / Accepted: 27 December 2023 / Published online: 25 January 2024 © The Author(s) 2024 Abstract Objectives The primary aim of the present study was to compare head and neck cancer treatment modality surgery and surgery with radiotherapy or chemoradiotherapy alone for dental implant (DI) survival. The second aim was to evaluate the prevalence of mucosal overgrowth around DI after treatment with or without mucosal grafts. Materials and methods An observational retrospective study consisted of 59 patients with malignant head and neck tumors that received DI between 2015 and 2019. Treatment modalities together with information on oral rehabilitation with DI, prevalence of mucosal overgrowth, and precursor lesions were gathered from the hospital records. Radiation doses were determined using a sum of three-dimensional dose distributions. Results Overall DI survival rate was 88%, in irritated jaw 89%, and in nonirradiated jaw 88% in this observational period (p = 0.415, mean follow-up was 2 years 10 months, range 9–82 months) . Mucosal overgrowth was found in 42 of 196 implants (21%), of which 36 cases (86%) were associated in grafted areas (p < 0.001). Oral lichen planus/lichenoid reaction was diagnosed in 14 of all 59 (24%) oral cancer patients. Conclusion Implant survival was not significantly influenced by radiation therapy in this observational period. In grafted bone, implant survival was significantly inferior than in native bone. Mucosal overgrowth around implants was more common in mucosal grafted areas versus nongrafted. Clinical relevance This study demonstrates the impact of grafted bone to dental implant survival rate and mucosal overgrowth. Keywords Dental implant · Head and neck cancer · Radiation therapy · Chemoradiotherapy · Oral squamous cell carcinoma Introduction Treatment of oral cancer is based on surgical therapy with or without radiotherapy or chemoradiotherapy [1] . Treatment options depend on several factors, such as the type and stage of the tumor and the patient’s general health. Surgical resection is the most well-established mode of initial definitive treatment for a majority of oral cancer patients, and in general, early-stage tumors are managed by a single-modality * Viivi Mattila [viivi.mattila@hus.fi](viivi.mattila@hus.fi) 1 Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland surgical treatment. Reconstructive surgery, mainly using microvascular free flaps, is often required to restore functional or esthetic loss of tissue. Dental implant treatment is the preferred method of replacing missing teeth today. The survival rate of implant treatment varies from 90 to 97% during 5 to 10 years of follow-up in patients who are otherwise healthy and without oral cancer [2–4] . However, oral carcinoma patients may have specific features for prosthetic rehabilitation/reconstruction after ablative surgery and/or radiotherapy/chemoradiotherapy, as soft and hard tissue defects. These anatomical alterations after surgical treatment of cancer affect oral function, chewing, swallowing, speech, and esthetic appearance. In addition, radiotherapy and chemoradiotherapy may cause side effects such as trismus, bone healing problems, mucositis, xerostomia, taste disturbances, and further infections like caries, candida, and periodontal infections. The placement of DI-assisted rehabilitation prostheses in patients with oral cancer has shown a high degree of satisfaction and

FAQs

What were the study’s primary and secondary aims?

The primary aim was to compare treatment modalities for dental implant survival in head and neck cancer patients. The secondary aim was to evaluate how often mucosal overgrowth occurred around implants after treatment with or without mucosal grafts.

How many patients and implants were included, and what was the overall DI survival rate?

The study involved 59 patients and 196 implants. The overall DI survival rate was 88% over the observational period (mean follow-up 2 years 10 months).

Did radiotherapy significantly affect implant survival, and where was mucosal overgrowth most common?

Implant survival was not significantly influenced by radiotherapy during the observational period. Mucosal overgrowth was more common in mucosal grafted areas, with 36 of the 42 overgrowth cases occurring in grafted regions.

Sep 21, 2026

Uploaded by Logic