Within the limitations of the current review, it can be concluded that implant survival in autogenous bone grafts in H&N oncology patients appears to be promising with implant survival being reported at over 80% in 16 of the 20 studies included with 11 of these reporting implant survival of over 90% in follow-up ranging from 3 months [28] to 15 years [5]. However, there is a lack of good quality evidence in the way of prospective studies and randomised control trials. A lack of long-term survival studies with sufficient implant and patient numbers was identified, and therefore, the results of the present review should not be extrapolated to longer follow-up times. Prognostic factors affecting implant survival in autogenous bone grafts were also reviewed with higher implant failure in autogenous bone grafts being reported in implants placed into irradiated autogenous bone grafts. Weak evidence suggesting implant failure was higher in non-vascularised in comparison with vascularised autogenous bone grafts and that implant failure was greater in primary placed implants in vascularised bone grafts in this cohort was identified. Implant success was lower than implant survival and was most commonly related to peri-implant disease and an inability to prosthetically to restore the implant. This was predominantly related to unfavourable peri-implant soft tissue which is frequently found around implants placed into combined bone and soft tissue flaps.

In order to understand the use of implants in autogenous bone grafts in H&N oncology patients larger, well-designed prospective studies are required. There needs to be clear set definitions of implant survival and success and appropriate presentation and statistical analysis of the data so that studies can be brought together to enable meta-analysis.

H&N:

Head and neck

MINORS:

Methodological Index for Non-Randomized Studies

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

QoL:

Quality of life