Oral Rehabilitation in Irradiated Patients: Implant- or Tooth-Supported Fixed Prosthesis? A Clinical Report

  • Somayeh Allahyari Department of Dental Technology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Cranial Irradiation, Osteoradionecrosis, Dental Implants, Dental Caries


Cranial radiotherapy has several side effects. One of the most important complications is radiation caries that endangers the treatment prognosis. In the literature, the use of crowns and bridges for irradiated patients has been suggested as a contraindication. In addition, due to the risk of osteoradionecrosis (ORN), there are doubts about tooth extraction and implant placement. Here, we present a treatment sequence and recalls for an irradiated young patient. For irradiated patients, it is recommended to replace teeth with implants when there is no possibility for supragingival prosthetic margin.


1. Ray-Chaudhuri A, Shah K, Porter RJ. The oral management of patients who have received radiotherapy to the head and neck region. Br Dent J. 2013 Apr;214(8):387-93.
2. Gupta N, Pal M, Rawat S, Grewal MS, Garg H, Chauhan D, et al. Radiation-induced dental caries, prevention and treatment - A systematic review. Natl J Maxillofac Surg. 2015 Jul-Dec;6(2):160-6.
3. Specht L. Oral complications in the head and neck radiation patient. Introduction and scope of the problem. Support Care Cancer. 2002 Jan;10(1):36-9.
4. Naidu MU, Ramana GV, Rani PU, Mohan IK, Suman A, Roy P. Chemotherapy-induced and/or radiation therapy-induced oral mucositis--complicating the treatment of cancer. Neoplasia. 2004 Sep-Oct;6(5):423-31.
5. Aguiar GP, Jham BC, Magalhães CS, Sensi LG, Freire AR. A review of the biological and clinical aspects of radiation caries. J Contemp Dent Pract. 2009 Jul 1;10(4):83-9.
6. Yesilyurt C, Bulucu B, Sezen O, Bulut G, Celik D. Bond strengths of two conventional glass-ionomer cements to irradiated and non-irradiated dentin. Dent Mater J. 2008 Sep;27(5):695-701.
7. Walker MP, Wichman B, Cheng AL, Coster J, Williams KB. Impact of Radiotherapy Dose on Dentition Breakdown in Head and Neck Cancer Patients. Pract Radiat Oncol. 2011;1(3):142-48.
8. Beech N, Robinson S, Porceddu S, Batstone M. Dental management of patients irradiated for head and neck cancer. Aust Dent J. 2014 Mar;59(1):20-8.
9. David LA, Sàndor GK, Evans AW, Brown DH. Hyperbaric oxygen therapy and mandibular osteoradionecrosis: a retrospective study and analysis of treatment outcomes. J Can Dent Assoc. 2001 Jul-Aug;67(7):384.
10. Hancock PJ, Epstein JB, Sadler GR. Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc. 2003 Oct;69(9):585-90.
11. Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14(3):213-25.
12. Omer O, MacCarthy D, Nunn J, Cotter E. Oral health needs of the head and neck radiotherapy patient: 2. Oral and dental care before, during and after radiotherapy. Dent Update. 2005 Dec;32(10):575-82.
13. Pradier O, Hille A, Schmiberger H, Hess CF. Monitoring of therapy in head and neck patients during the radiotherapy by measurement of Cyfra 21-1. Cancer Radiother. 2002 Feb;6(1):15-21.
14. Jawad H, Hodson NA, Nixon PJ. A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Br Dent J. 2015 Jan;218(2):65-8.
15. Schiødt M, Hermund NU. Management of oral disease prior to radiation therapy. Support Care Cancer. 2002 Jan;10(1):40-3.
16. Falcao B, Januzzi E, Santos F. Oral Rehabilitation Following Head and Neck Cancer Treatment–Review of literature. J Palliat Care Med. 2015 Feb;5:208.
17. Ihde S, Kopp S, Gundlach K, Konstantinović VS. Effects of radiation therapy on craniofacial and dental implants: a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jan;107(1):56-65.
18. Granström G. Placement of dental implants in irradiated bone: the case for using hyperbaric oxygen. J Oral Maxillofac Surg. 2006 May;64(5):812-8.
19. Esposito M, Grusovin MG, Patel S, Worthington HV, Coulthard P. Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD003603.
20. Barrowman RA, Wilson PR, Wiesenfeld D. Oral rehabilitation with dental implants after cancer treatment. Aust Dent J. 2011 Jun;56(2):160-5.
21. Schoen PJ, Raghoebar GM, Bouma J, Reintsema H, Vissink A, Sterk W, et al. Rehabilitation of oral function in head and neck cancer patients after radiotherapy with implant-retained dentures: effects of hyperbaric oxygen therapy. Oral Oncol. 2007 Apr;43(4):379-88.
22. Shaw RJ, Sutton AF, Cawood JI, Howell RA, Lowe D, Brown JS, et al. Oral rehabilitation after treatment for head and neck malignancy. Head Neck. 2005 Jun;27(6):459-70.
How to Cite
Allahyari S. Oral Rehabilitation in Irradiated Patients: Implant- or Tooth-Supported Fixed Prosthesis? A Clinical Report. Front Dent. 16(4):319-324.
Case Report