Systematic Review

Mandibular implant stability in oral cancer patients: a systematic review

CHU Nantes: Centre Hospitalier Universitaire de Nantes, Nantes, France

^* Correspondence: davidbrasme1@gmail.com

Received: 23 November 2024
Accepted: 10 February 2025

Abstract

Introduction: Dental implants have been increasingly used in cancer patients for dental rehabilitation of the previously irradiated mandible and in mandibular reconstruction via fibula grafts but there is still debate surrounding the osseointegration process of implants in both situations. Implant stability, measured with the resonance frequency analysis, can provide a better understanding of osseointegration. The objective of this systematic review was to assess the changes in the implant stability for dental implants over time in oral cancer patients and to determine whether the measurement of the Implant Stability Quotient at the time of implant placement could be a predictive factor of implant failure. Materials and methods: An electronic search of PubMed, ScienceDirect, and Google Scholar databases was performed prior to August 2023 and complemented by a manual search. The protocol of this systematic review was conducted in accordance with the PRISMA guidelines and registered in the International Prospective Register of Systematic Review (PROSPERO) database under number CRD42022378722. Studies reporting on dental implants, with measurement of the Implant Stability Quotient on mandibles, irradiated or not, with or without a fibula graft were included. Results: The search yielded 25 articles: 20 focused on native mandibles, 2 focused on irradiated mandibles and 3 focused on fibula grafts. The mean Implant Stability Quotient for native mandibles and fibula grafts was significantly higher than that for irradiated mandibles (p < 0.05). There was no significant difference in Implant Stability Quotient scores between native mandibles and fibula graft at any time point. A correlation between implant failure-Implant Stability Quotient could not be established due a to lack of available data in the relevant studies. Discussion: Notwithstanding the disparities in ISQ, the overall changes in ISQ over time in the three groups appeared to be homogeneous. The success rate of implants placed in the native mandible (97.38%) was found to be higher than that of implants placed in a fibula graft (94.59%) or irradiated mandible (87.2%). Despite the higher percentage of failures observed, the overall success rate confirming that dental implants are a reliable therapeutic option for cancer patient rehabilitation. Conclusion: Based on this review, it can be concluded that the change in the Implant Stability Quotient appeared to be comparable across all bone types. The mean Implant Stability Quotient in native mandibles and free fibula grafts was significantly higher than in irradiated mandibles. It was not possible to determine whether measuring the Implant Stability Quotient during implant insertion could predict implant failure.