How old is old for implant therapy in terms of early implant losses?

Abstract

ObjectivesTo assess, retrospectively, whether older age has an impact on implant osseointegration when compared with younger age.MethodsAll patients ≥65 years old at implant installation, in an university setting over a time‐period of 11.5 years, with complete anamnestic data and follow‐up until prosthetic restoration were included, and any early implant loss (EIL; i.e. lack of osseointegration prior to or at the time‐point of prosthetic restoration) was recorded. Further, one implant, from each of the elderly patients, was attempted matched to one implant in a younger patient (35 to <55 years old at implant installation) from the same clinic based on (a) gender, (b) implant region, (c) smoking status and (d) bone grafting prior to/simultaneously with implant installation. The potential impact of various local and systemic factors on EIL in the entire elderly population, and in the matched elderly and younger patient group was statistically assessed.ResultsFour hundred forty‐four patients ≥65 years old (range 65.1–91.3; 56.8% female) receiving 1,517 implants were identified; 10 patients had one EIL each (implant/patient level: 0.66/2.25%). Splitting this patient cohort additionally into four age groups [65–69.9 (n = 213), 70–74.9 (n = 111), 75–79.9 (n = 80) and ≥80 (n = 40)], EIL was on the implant level 0.41, 0.83, 0.34 and 2.26%, respectively, (p = .102) and on the patient level 1.41, 2.70, 1.25 and 7.50%, respectively, (p = .104); multilevel analysis showed weak evidence of association of increasing age with higher EIL rate (p = .090). Matching was possible in 347 cases, and 5 (1.44%) and 9 (2.59%) EIL in the elderly and younger patients, respectively, were observed (p = .280). EIL could not be associated with any systemic condition or medication intake.ConclusionsElderly patients ≥65 years old presented a similarly low EIL rate as younger patients 35 to <55 years old, while patients ≥80 years old may have a slight tendency for a higher EIL rate. Hence, ageing does not seem to compromise osseointegration, and if at all, then only slightly and at a later stage of life.

How old is old for implant therapy in terms of implant survival and marginal bone levels after 5–11 years?

“…Further, a previous study based on a larger group of patients from this clinic (i.e. the patients included herein are part of this previous publication) assessed specifically EIL (Bertl et al, 2019); in 444 patients ≥65 years of age at the time of implant installation with 1517 implants, EIL rate was 0.66% on the implant level. In the same study (Bertl et al, 2019), 347 patients of the elderly group were also matched to a younger patient cohort (i.e.…”

“…the patients included herein are part of this previous publication) assessed specifically EIL (Bertl et al, 2019); in 444 patients ≥65 years of age at the time of implant installation with 1517 implants, EIL rate was 0.66% on the implant level. In the same study (Bertl et al, 2019), 347 patients of the elderly group were also matched to a younger patient cohort (i.e. <55 years old at implant installation), based on specific criteria; EIL was shown to be 1.44 vs. 2.59%, respectively, in the matched cohorts.…”

“…This specific timeframe was chosen to allow a 5‐year follow‐up at the time of screening. Further, it should be noted that the population included herein is also part of a previous publication (Bertl et al, 2019).…”

“…Wound healing might be compromised due to ageing itself, but also due to a higher prevalence of chronic diseases in this group of patients, which are interfering with the wound healing process (Chrcanovic et al, 2014; Wood et al, 2004). Recently it was reported that ageing does not seem to compromise osseointegration in terms of higher numbers of early implant losses (EIL) (Bertl et al, 2019). However, compromised wound healing is not the only concern in terms of dental implant therapy in elderly patients; the ability to maintain a sufficient oral hygiene, to seek regularly supportive treatment and to handle removable restorations appear even more important for a successful treatment outcome and avoidance of biological complications on the long‐term (Schimmel et al, 2017).…”

Patient’s Risk Factors for Dental Implant Success and Failure (A Retrospective Study)

“…Effective implants must have no pain or discomfort, no mobility, no infection and bone loss of less than 0.2 mm / year in the first year of loading 7 .The early implant failure might due to local factors like, poor quality and quantity of bone, overheating, infection or contamination, more bone compression necrosis and low primary stability or systemic factors like, patient medical conditions and smoking 8 . While delayed implant failure mainly related to periimplant diseases or prosthetic problems as, improper design, overloading, long cantilever and occlusion problems 9,10 . This retrospective study was designed to evaluate the odds ratio for the patients systemic and local risk factors associated with dental implant success.…”