Following a maxillectomy, I have had the fibula flap reconstruction. I have also had a radial forearm flap added to improve blood flow and help in reconstruction. I have had 60Gy RT post the fibula and pre the forearm.

Somewhere in the planning someone forgot to tell the surgeon that implants are not suitable for folk who have had radiation over 50GY. Until very recently the surgeons were telling me that implants were the way to go. Then they found out that that implants are not recommended. Too late, the surgery is complete, and so it the RT.

My mouth is shallow with little sulcus (gum). I will have difficulty with any denture or plate, as I have 8 teeth missing and the remaining 6 will have to carry the load. There is a chance that an ill fitting denture could cause more lesions and increase the risk of cancer. Dentures need to be regularly altered, and a new denture every two years is recommended. A chrome plate is a better option, but ensuring it does not move is more tricky, and it raises issues regarding long term oral health.

There are no low risk options for me. I am healthy, fit and in my fifties. I am finding it difficult to get good quality information from my team.

Suggestions?

Hello, my understanding re the implants is the same as yours.
My Husband Kris has had ongoing Dental issues post his radiation and consequent salvage surgery. The Head&Neck oncology Dentist gave us the same information that you have. Implants would never be an option. He also advised against dentures for the same reason - reduced blood supply and high risk of both osteoradionecrosis and recurrence of cancer.
Here in New Zealand it seems we have limited to no options. Maybe someone from the U.S.can better guide us here.
Tammy

What about a bridge? I'm not sure if that is an option for you since you only have 6 teeth. I lost my 4 lower front teeth because of the side effects of radiation. I looked into a number of options and ended up with a 10-tooth bridge to replace the missing 4 teeth. The downside is that they had to destroy the 3 teeth on each side of the missing teeth in order to have enough support for the bridge. By destroy I mean they had to grind down and cap my otherwise healthy teeth in order to create the bridge,

I've heard of a few people who had implants post-RT, but in my case it was not recommended. From my understanding implants need healthy bone with good blood flow in order to be successful and radiated bone is already compromised.

Are you familiar with hyperbaric oxygen therapy (HBOT)? HBOT is recommended post RT for any invasive dental work such as extractions. I don't know if this would help in your situation, but if you find a doctor to do implants my guess is that HBOT would be part of the process.

Wishing you the best!