Implants in disabled patients: A review and update

Abstract

The range of indications for dental implants has broadened enormously owing to their predictability and the improvement of patient satisfaction in terms of stability, comfort, aesthetics and functionality. The aim of this article is to review those indications in patients with mental or physical disabilities as the difficulty to cope with oral hygiene often leads to teeth extraction, adding edentulousness to the impairments already present. Following that goal, available literature in Pubmed database, Scopus, Web of Knowledge and The Cochrane Library database about dental implants placement in these patients has been reviewed, assessing the variables of each study: number of patients, sex, average age, oral hygiene, parafunctional habits, impairment, bone quality, protocol of implant surgery, necessity of deep intravenous sedation or general anesthesia, follow-up period and number of failures. The comparison with studies involving other patient populations without mental or physical impediments did not show statistically significant differences in terms of the failure rate recorded. Although there is not much literature available, the results of this review seem to suggest that osseointegrated oral implants could be a therapeutic option in patients who suffer from any physical or psychological impairment. The success of an oral rehabilitation depends mainly on an adequate selection of the patients. Key words:Implants, disabled, sedation.

Prosthodontic Rehabilitation for a Patient with Down Syndrome: A Clinical Report

“…The indications of dental implant treatment are based on several local and systemic factors, which impact bone or soft tissue health. These factors should be carefully evaluated before proceeding to any dental implant therapy to predict the success of the overall treatment outcome . Prosthodontic rehabilitations with implant therapy have been successful treatments for special care patients, including individuals with Down syndrome .…”

“…However, most dentists do not consider implant placement as a restorative option for patients with Down syndrome because of concerns about their cooperation with the overall treatment, compliance with the dental maintenance, and the quality and the quantity of the existing bone. Thus, the literature includes only a few documented cases of rehabilitation with dental implants for patients with Down syndrome . Furthermore, individuals with intellectual disabilities may exhibit low levels of self‐care and maintenance that can jeopardize their oral environment and compromise the longevity of implant restorations …”

Management of dental avulsion in a child with severe intellectual disability: Case report

“…A recent review by Romero-Pérez et al compiled evidence and supports implant-supported prosthesis for children with special health needs. 10 Since replantation favors the future possibility for implant placement, an attempt was made to splint and retain the teeth in position with the best possible care.…”

A preliminary report on dental implant condition among dependent elderly based on the survey among Japanese dental practitioners

“…Treatment with implants in itself has been successfully performed even in older adults [4] and people with disabilities [5] as long as the patients are appropriately managed. It is likely that older adults who are receiving long-term care and unable to travel to the dentist’s office have difficulty continuing to perform oral self-care and receive professional oral care due to the complexity of the form of prosthesis and the problem of the implant placement [6, 7].…”