I'm 18 months after surgery - left bottom side marginal mandibulectomy. I hadn't contemplated getting implants in the flap covered gum but a new consultant looked at my mouth and asked if I had thought of it. Moreover I'll lose all my bottom teeth eventually and will possibly need implants on my good side. I assume I would get these free under our health system so cost is not a factor right now.

I've looked up the posts on this topic but just want to get the latest info. Have people had implants in radiated or non-radiated areas of their mouth? How did it go?

After radiation treatments, implants could be off the table. Of course every patient is an individual and this would be a case by case basis. Ive seen some members have implants and they have worked out very well. Make sure your dental specialist is very experienced in treating OC patients who have had rads. You do NOT want to end up with much bigger issues later like ORN. I hope you are able to get implants and this works out to give you beautiful new teeth

Hi Alpaca,

Cost aside, getting implants seems like a complex process as HBOT is usually performed on top of the numerous procedures to put in an implant.

Personally, one of the major long term side effects lurking in my mind from time to time is ORN. I'm concerned doing anything that might upset the condition of my jaw bone. The reason for implants would have to be substantial to offset the added risks of potential ORN related issues.

If you do pursue implants make certain you find multiple specialists who have done this in oral cancer patients receiving radiation with similar painting profiles. I'd also want to know they have experience over years with patients and how things develop over time.

Good luck
Don

Alpaca, we've had a few discussions on the forum on dental issues. My radiation was focused on my lower jaw, right side. My 4 lower front became loose, were removed, and I had a 10-tooth bridge made to replace my missing lower teeth. I wasn't very happy with the bridge as it was causing bite issues, and because of this an upper left molar cracked and had to be extracted. This tooth was not in the radiation field and from what my doctors have indicated my jaw bone is healthy in this area.

The oral surgeon at my consult before extraction indicated an implant was possible (would do some tests to make sure the jawbone was healthy). Just a few weeks later at a follow-up visit, he said he wouldn't recommend it. He was in a hurry so I didn't get a chance to question him further.

I see two different ENTs - one locally and another at Johns Hopkins. Both ENTs said it is possible, but recommend caution before proceeding.

I see a prosthodontist as my general dentist, and recently switched to a new one. He is in the "no implant" camp.

In the mean time, I decided to get braces on my upper teeth to improve my bite and hopefully prevent any additional cracked teeth and enable me to use my front teeth to chew. The braces will be on until sometime next year, so the decision on implant vs bridge (3-tooth) to replace my missing molar is on hold. Right now I'm leaning on going the "safe" route with the bridge, but I just don't like the idea of destroying two more healthy teeth to create the bridge. I plan on consulting with a few more dental professionals about getting an implant, but that won't be until next year. I'm sure they will recommend more HBOT if I pursue the implant.

One of the reasons mentioned against an implant in my case is that it is an upper molar and the upper jaw bone is smaller than the lower jaw bone and is next to my sinus cavity. There is concern that could cause issues with my sinus cavity if the implant is too deep.

In your case I wouldn't rule implants out, just do your homework and consult with experienced doctors. I know a few OC survivors who have had implants, but don't know if they had any problems.

Please let us know what you decide. Good luck!

Thank you Susan and others for your feedback. I really didn't think it was a good idea to get implants on my radiated side and have never discussed that with my prosthodontist. The latter suggested implants on my lower good side when my lower teeth finally give up the ghost. I was initially horrified at the thought of having something artificial implanted into a problematic mouth but I'm now thinking that it could be an option (on the good side only) in the future. If I lose all my lower teeth one day, implants to hold a plate in will be the only option I think. Won't get ahead of myself right now. I don't usually think too far ahead but the throwaway comment by the ENT consultant made me think that there are some options for the future. Remember when we used to groan about a regular trip to the dentist!

Alpaca, I'll throw in a bit of personal experience with implants here as well. I am extremely fortunate in that I have a close relative who is an oral surgeon. He has played an important role in my treatment from the first surgery forward.

We began talking about implants about three years out. it was not advised at that point, but for the following five years we revisited the possibility every few months. Finally, 8 1/2 years out, he felt it worth trying. Initially, he'd planned on doing a complete run of implants top & bottom ( I should add I lost 50% of my mandible, which was successfully replaced witha fibular graft) After a great many scans, x-rays, exams & consultations, we decided instead to do a full implant field on the upper, and only four on the mandible, with three in healthy, unradiated bone , and the fourth into bone on the edge of the radiation field. The idea being that the bone there would be adequate to serve as a positioning anchor without taking too much loading from bite forces. Instead of individual crowns, he constructed a full denture, without any of the normal ridgeline support. Instead, at four places along the length of the appliance, the implant pegs snap connect with the plate, allowing me to remove it for cleaning.

The procedures were completed a year ago and I have been completely trouble free. I do have to pay close attention to cleanliness around the implant pegs, however I have had no infections of any kind. The lower is stable enough that I am able to eat EVERYTHING once again, including steak & even previously impossible things to masticate, like lettuce & spinach.

That said, I don't think I would risk an implant into radiated bone...there are simply too many potential problems. I hope you can reach a point where you're comfortable with the choices you have. For me, it's worked out brilliantly