Summary of evidence

Dental implants are now perceived to be a vital part of the clinician’s armamentarium in the provision of oral and dental rehabilitation for patients with acquired deformity following management of their H&N cancer, and therefore, this systematic review is relevant to clinicians and stakeholders involved in the treatment and management of H&N cancer patients specifically with those involved in placing or utilising dental implants to assist in the dental/oral rehabilitation of H&N cancer patients.

The main findings from this systematic review did however identify, with the exception of a small number of studies, implant survival (at an implant level) in autogenous bone grafts was clinically promising (> 85%); however, this appears to be lower than implants placed into the native bone in H&N cancer patients. Weak evidence was identified which suggests that radiotherapy is a prognostic factor affecting implant survival in this patient cohort; however, this has also been reported as having a detrimental effect on implant survival in the native bone within the literature. The type of autogenous bone graft donor site and implant survival was also reviewed within the included studies that compared varying autogenous bone graft donor sites and implant survival. There is some weak evidence from these studies to suggest that implants placed into vascularised bone grafts appear to have a higher survival rate in comparison to non-vascularised bone grafts within this review. This evidence however is unreliable, due to the clear lack of studies reporting on implant survival in non-vascularised bone grafts and thus the subsequent number of implants and patients included within this review.