TITANIUM OSSEOINTEGRATED IMPLANTS COMBINED WITH HYPERBARIC-OXYGEN THERAPY IN PREVIOUSLY IRRADIATED MANDIBLES

Statement of problem. Treatment for head and neck malignancies commonl y involves radiation therapy. As a result of this therapy the vascular supply to irradiated structures is altered and results in decreased t issue perfusion. In addition to vascular changes, bony structures unde rgo a reduction in osteoblastic and osteoclastic activity. These tissu e alterations, especially in the mandible, enhance the risk of osteora dionecrosis. To avoid this occurrence, many patients who have undergon e radiation therapy do not receive elective preprosthetic surgeries, i ncluding implant therapy. Purpose of study and methods. This report pr esents the preliminary results of placing 18 titanium screw implants i nto previously irradiated mandibles in conjunction with hyperbaric oxy gen therapy. Results. Of the 18 implants placed, 17 (94%) were judged to be osseointegrated at the abutment connection. One implant did not receive an abutment and was ''put to sleep.'' The remaining 16 (88%) w ere used for prosthetic rehabilitation. Conclusion. The use of implant s in irradiated tissues may provide a means of enhancing prosthetic re habilitation while reducing the risk of tissue trauma that may develop into osteoradionecrosis.