Background: Patients who undergo surgical management of oral cancer may greatly benefit from an implant-supported prosthesis. This study reports on the clinical experience of dental implant placement in patients following resection of oral cancer over a 15-year period. Controversies including the use of dental implants in irradiated tissues, and hyperbaric oxygen treatment will also be discussed. Methods: Thirty-one patients who had dental implants placed as part of their oral rehabilitation between 1992 and 2007 were investigated. Demographic data and factors including implant survival, type of prosthesis provided, radiotherapy and the hyperbaric oxygen therapy were analysed. Results: In this retrospective study, there was a retention rate of 110 implants from a total of 115 implants placed. A high rate of implant retention was found, with 5 implant failures from a total of 115 implants placed. The 5 failed implants occurred in free flap bone that had been irradiated. Conclusions: Dental implants provide an important role in the oral rehabilitation of oral cancer patients. There may be an increased risk of implant failure in free flap bone that has been irradiated.

Biologic and technical complications are widely reported in the dental literature and often compromise the functional and/or aesthetic features of fixed, implant‐supported prostheses. Managing complications without damaging or destroying a restoration is an obvious advantage of implant‐based dentistry where the option of prosthetic retrievability is almost always available. The technique of cross‐pinning uses a transverse screw to secure a prosthesis to a milled implant abutment, allowing prosthetic retrievability irrespective of dental implant alignment. This study presents guidelines for cross‐pinning implant‐supported prostheses based on resistance form, screw mechanics and natural tooth contours. The technical aspects of cross‐pinning are also discussed using examples from four implant systems.

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