Effect of Implant Surface and Radiation Dose on Crestal Bone Loss in Irradiated Patients: 1-Year Preliminary Outcomes

OBJECTIVES: Implant-supported prosthetic rehabilitation is frequently required in head and neck cancer patients but carries an elevated risk of impaired osseointegration and peri-implant bone loss. Hydrophilic implant surfaces have demonstrated improved early osseointegration in preclinical studies. However, clinical evidence, especially in irradiated patients, remains limited. This study aimed to compare short-term clinical and radiologic outcomes of hydrophilic implants versus conventional implants placed in irradiated bone. MATERIALS AND METHODS: In this study, 107 implants (conventional surface: n=53; hydrophilic surface: n=54) were placed in 21 irradiated patients with head and neck cancer using a split-mouth design. Panoramic radiographs were obtained at baseline, 6 months, and 12 months, and mesial and distal crestal bone loss was assessed. Further, effects of implant surface and implant-specific radiation dose were evaluated. RESULTS: At 12 months, hydrophilic implants demonstrated significantly reduced crestal bone loss compared with conventional implants both mesially (0.6±0.7 versus 0.9±0.7 mm; P<0.001) and distally (0.5±0.4 versus 0.9±0.6 mm; P<0.001). Implant location and radiation-dose category did not show statistically significant associations with bone loss over time. CONCLUSIONS: Hydrophilic implant surfaces were associated with reduced early crestal bone loss in irradiated patients, while radiation dose exhibited no measurable impact within the first year. This study is the first to demonstrate a potential benefit of hydrophilic implants in irradiated patients, including those with autologous bone grafts. Hydrophilic implants may represent a promising option for implant rehabilitation in this high-risk patient population.