Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta‐analysis

Abstract

Objectives: This review evaluated implant survival in geriatric patients (≥75 years) and/or the impact of systemic medical conditions. Materials and Methods: Systematic literature searches were performed to identify studies reporting on geriatric subjects with dental implants and on implant patients who had any of the seven most common systematic conditions among geriatric patients. Meta-analyses were performed on the postloading implant survival rates. The impact of systemic medical conditions and their respective treatment was qualitatively analyzed.Results: A total of 6,893 studies were identified; of those, 60 studies were included.The fixed-effects model revealed an overall implant survival of 97.3% (95% CI: 94.3, 98.7; studies = 7) and 96.1% (95% CI: 87.3, 98.9; studies = 3), for 1 and 5 years, respectively. In patients with cardiovascular disease, implant survival may be similar or higher compared to healthy patients. High implant survival rates were reported for patients with Parkinson's disease or diabetes mellitus type II. In patients with cancer, implant survival is negatively affected, namely by radiotherapy. Patients with bone metastases receiving high-dose antiresorptive therapy (ART) carry a high risk for complications after implant surgery. Implant survival was reported to be high in patients receiving low-dose ART for treatment of osteoporosis. No evidence was found on implant survival in patients with dementia, respiratory diseases, liver cirrhosis, or osteoarthritis.Conclusions: Implant prostheses in geriatric subjects are a predictable treatment option with a very high rate of implant survival. The functional and psychosocial benefits of such intervention should outweigh the associated risks to common medical conditions.

Advances in implant therapy in North America: Improved outcomes and application in the compromised dentition

“…Several more recent studies have concluded that diabetic patients may have similar positive outcomes to those found with healthy, nondiabetic patients . Their findings have led to a more rigorous and open scientific investigation of the impact systemic factors have on implant therapy success.…”

“…That is, to begin to fully and appropriately operationalize implant therapy for medically compromised patients, we will need not only to continue to challenge existing dogma and fully define the long‐term risks, but will also need to understand the benefits gained from implant therapy as an important contribution to improved oral and systemic health . It is perhaps one of the more subtle contributions from these earlier studies challenging the longstanding implications for diabetes in implant therapy that it has taken forward similar considerations across a range of systemic conditions …”

“…91 Several more recent studies have concluded that diabetic patients may have similar positive outcomes to those found with healthy, nondiabetic patients. [98][99][100][101][102] (Table 4). 99,100,103,104 Recent systematic reviews have begun to address the potential for long-term implant sequelae associated with diabetes (Table 5).…”

Group 4 ITI Consensus Report: Risks and biologic complications associated with implant dentistry

“…Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta-analysis (Schimmel, Srinivasan, McKenna, Müller, 2018).…”

Evolution of in vivo assessed retention forces in one‐piece mini dental implant‐retained mandibular overdentures: 5‐Year follow‐up of a prospective clinical trial

“…However, the placement of standard diameter implants severely resorbed mandibles can be challenging and might necessitate bone augmentation procedures . It has to be considered that advanced surgical procedures are usually accompanied by an element of risk for augmenting biological complications, and more so, especially in the age‐advanced medically compromised patients . Therefore, the adoption of minimally invasive treatment concepts along with surgical procedures that have low morbidities seems a logical alternative.…”