Osseointegrated implants in irradiated bone:: A case-controlled study using adjunctive hyperbaric oxygen therapy

Purpose: The current investigation was undertaken to study whether osseointegration of implants in irradiated tissues is subject to a higher failure rate than in nonirradiated tissues. It further aimed to study whether hyperbaric oxygen treatment (HBO) can be used to reduce implant failure. Patients and Methods: Seventy-eight cancer patients who were rehabilitated using osseointegrated implants between 1981 and 1997 were investigated. Three groups of patients were compared: irradiated (A), nonirradiated (B), and irradiated and HBO-treated (C). In addition, 10 irradiated patients who had lost most of their implants received new ones after HBO treatment. These were compared as a case-control group. Results: Implant failures were highest in group A (53.7%). Implant failure was 13.5% in group B and 8.1% in group C, The difference between group A and the other two groups was statistically significant (P =.001 to .0023, Mantell's test). HBO significantly improved implant survival in the case-control group from 34 of 43 implants lost to 5 of 42, lost (P =.0078). Conclusions: Implant insertion in irradiated bone is associated with a higher failure rate. Adjuvant HBO treatment can reduce the failures.