The Best Time to Dental Implant Placement in Patients with Head and Neck Cancers: An Ever-going Debate

Abstract

With 500,000 new cases diagnosed each year, head and neck cancers (HNC) are among the most prevalent cancers in the world. The most effective organ-sparing therapy for patients with locally advanced HNC is concurrent chemoradiotherapy (C-CRT). Many HNC patients lose multiple teeth and develop soft and hard tissue defects over the course of the disease and treatment, leading to functional limitations and cosmetic deformity. Such devastating effects harm the patient's ability to eat, chew, and swallow as well as their psychological, financial, and social well-being. Additionally, multiple tooth losses and subpar oral rehabilitation services can cause cachexia, rapid weight loss, and weakened immunity. The use of conventional prostheses to address tooth losses may not be permitted due to detrimental changes in the structure of the oral cavity. Conventional prostheses may aggravate the harmful side effects of radiotherapy, including xerostomia, mucositis, and a deterioration of bone healing processes. Dental implants may be a better choice for oral rehabilitation. However, because the area of bone involved in implant placement is frequently within the irradiation zone, dental implant planning and timing in HNC patients can be extremely difficult. Additionally, the placement of dental implants may precipitate some specific side effects of cancer treatments, such as osteoradionecrosis. Because the best time to use dental implants is one of the essential components of successful dental rehabilitation for HNC survivors and has not yet been clarified in the literature, this review article aims to gather and provide information in the head and neck region by reviewing the available literature.