Impact of Chemotherapy and Radiotherapy on Osseointegration and Survival of Dental Implants: A Systematic Review and Meta-Analysis.

Abstract

Dental implants are widely used in oral rehabilitation, and their efficacy depends on proper osseointegration. In cancer patients, chemotherapy and radiotherapy may adversely affect bone healing and implant stability. Despite increasing clinical use, the effect of these therapies on implant survival remains controversial. To comprehensively evaluate the impact of chemotherapy and radiotherapy on the osseointegration and survival of dental implants in cancer patients. In accordance with the PRISMA criteria, a systematic search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library. Relevant studies involving patients undergoing chemotherapy and/or radiotherapy and reporting implant outcomes were included. Data extraction included sample size, number of implants, survival and failure rates, and follow-up duration. The odds ratios and mean differences were computed with a 95% confidence interval in a meta-analysis that was conducted using Review Manager (RevMan 5.4.1). The I² statistic was used to evaluate heterogeneity. The analysis involved four studies that were published between 2015 and 2026. The findings demonstrated a general trend toward lower implant survival rates and higher failure rates in patients exposed to chemotherapy and/or radiotherapy compared to controls. Pooled analysis indicated no statistically significant variation in implant survival (P = 0.24) or failure rates (P = 0.30) between the groups. Significant heterogeneity was observed among the studies. The follow-up period exhibited a statistically significant disparity among the groups (P = 0.0001). Dental implant outcomes may be adversely affected by chemotherapy and radiotherapy; however, this meta-analysis did not demonstrate a statistically significant overall effect. Results may have been influenced by variations in study design, sample size, and follow-up duration. A meticulous approach to patient selection and treatment planning is still necessary. Further high-quality studies are required to establish definitive clinical guidelines.