Please cite this article in press as: Korfage A, et al. Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years. Br J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.bjoms.2014.05.013 ARTICLE IN PRESS YBJOM-4279; No. of Pages 8 British Journal of Oral and Maxillofacial Surgery xxx (2014) xxx–xxx Available online at www.sciencedirect.com Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years Anke Korfage * , Gerry M. Raghoebar, James J.R. Huddleston Slater, Jan L.N. Roodenburg, Max J.H. Witjes, Arjan Vissink, Harry Reintsema Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands Received 12 July 2013; accepted 26 May 2014 Abstract We aimed to assess oral functioning, patients’ satisfaction, condition of peri-implant tissues, and survival of implants up to 14 years after their insertion in patients with oral cancer who had had mandibular overdentures placed over primary implants. Endosseous dental implants were inserted prospectively in the interforaminal region of the mandible during resection of the tumour in 164/180 patients with oral cancer. All 58 patients were evaluated by questionnaires and clinical assessments during a final assessment in 2012. Implant-retained mandibular overdentures were inserted, and prosthetic rehabilitation and oral functioning were not associated with primary site or stage of the tumour, number or type of implants inserted, or the type of reconstruction. Over time the peri-implant mucosa was usually free of inflammation. More implants were lost in patients treated by radiotherapy (27/318, 8.5%) than in those not so treated (1/206, 0.5%). Patients who had been treated by irradiation reported more problems in oral functioning and less satisfaction than those who had not. Patients with an implant-retained mandibular overdenture reported fewer problems in oral functioning than patients without an overdenture. Primary insertion of an implant should be routinely incorporated in the surgical planning for patients with oral cancer, as oral functioning in those wearing mandibular overdentures improved considerably and peri-implant health was at least reasonable. © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Keywords: head and neck cancer; edentulous; dental implants; quality of life; prosthodontics; patients’ satisfaction Introduction Resection of a tumour in the oral cavity can have a profound effect on oral functions such as chewing, swallowing, and intelligible speech. 1 Postoperative radiotherapy usually fur- ther compromises oral functioning. Changes in oral anatomy as a result of resection, and complications of radiotherapy such as xerostomia and intolerance of the denture-bearing * Corresponding author. Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Tel.: +31503613859; fax: +31503612831. E-mail address: a.korfage@umcg.nl (A. Korfage). mucosa to mechanical loading, limit prosthetic rehabilita- tion in these patients. 2 Prosthetic rehabilitation of edentulous patients after treatment of oral cancer is difficult and therefore often omitted. However, adequate prosthetic reha- bilitation is a pivotal factor for patients to regain oral function. 3 In healthy patients oral function can be improved using implant-retained mandibular overdentures, 4,5 and this treat- ment has become important in the rehabilitation of oral cancer patients as well. 6 Implants may be best inserted at the time of the resection (primary insertion of implants), 7–11 as many patients postpone or simply decline implant-based treatment if it is offered after resection of the tumour and postoperative radiotherapy. 12–14 http://dx.doi.org/10.1016/j.bjoms.2014.05.013 0266-4356/© 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.