Patients treated for oral cancer face many problems. Surgery on indication followed by additional radiotherapy, is the curative treatment of choice. Ablative surgery for oral cancer results in altered anatomical structures that may impair oral functions. Additional loss of function can be encountered due to significant side effects of postoperative radiation therapy.
Besides being permanently disfigured, they also suffer from diminished or lost essential oral functions, such as speech, chewing, and swallowing. Improvement of oral functions may be achieved by implant-supported prosthetic rehabilitation. The best timing for oral rehabilitation is subject to debate.
Implants can be placed primary, during ablative surgery or postponed which means more than 6–12 months after initial oncological treatment. Primary placed implants have the advantage that the implantation site has not been compromised as a result of radiotherapy, thereby bypassing the need for preventive antibiotics and hyperbaric oxygen therapy prior to implantation to reduce the risk of osteoradionecrosis in case of postponed implantation. However, the main disadvantage of primary implantation is that proper positioning of the implants is rather difficult. Especially if the tumour is located near the interforaminal region, the soft tissue contour is often not predictable, sometimes resulting in a non-functionally implant position for oral rehabilitation. Prosthetic evaluation in oral oncology patients needs of a thorough multidisciplinary pre-surgical examination for a well-established treatment planning. The primary curative intent of the oncological treatment and the prognosis for later prosthodontic rehabilitation have to be taken into account too.