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The International Journal of Oral & Maxillofacial Implants
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Int J Oral Maxillofac Implants 32 (2017), No. 2     17. Mar. 2017
Int J Oral Maxillofac Implants 32 (2017), No. 2  (17.03.2017)

Page 415-422, doi:10.11607/jomi.5361, PubMed:28291859


Short Dental Implants Retaining Two-Implant Mandibular Overdentures in Very Old, Dependent Patients: Radiologic and Clinical Observation Up to 5 Years
Maniewicz, Sabrina / Buser, Ramona / Duvernay, Elena / Vazquez, Lydia / Loup, Angelica / Perneger, Thomas V. / Schimmel, Martin / Müller, Frauke
Purpose: To describe the survival rate and peri-implant bone loss in very old patients dependent for their activities of daily living (ADL), treated with mandibular two-implant overdentures (IODs) in the context of a previously reported randomized controlled trial.
Materials and Methods: A total of 19 patients received two interforaminal Straumann implants (Regular Neck, 4.1 mm diameter, 8 mm length) that were subsequently loaded with Locator attachments, transforming their preexisting inferior conventional denture into an IOD. The primary outcome measures were implant survival rate and radiographically assessed peri-implant bone loss. Secondary outcome measures included peri-implant probing depth and Plaque Index scores, as well as implant mobility. Nutritional state (body mass index and blood markers) and cognitive state (Mini- Mental State Examination) were also analyzed.
Results: The patient cohort comprised eight men and 11 women with a mean age of 85.7 ± 6.6 years. The implant survival rate up to 5 years was 94.7%, with one early and one late implant failure. The mean loss of peri-implant bone height was 0.17 mm per year (95% confidence interval: 0.09 to 0.24; P < .001). Peri-implant probing depth and Plaque Index scores were low and stable during the first 2 years, and thereafter increased continuously. Correlation analysis suggests that a reduced cognitive function and nutritional state are not a particular risk factor for accelerated peri-implant bone loss.
Conclusion: The high implant survival and acceptable peri-implant health suggest that neither age nor dependency for the ADLs is a contraindication for the placement of implants. Nevertheless, close monitoring of the patients concerning a potential further functional decline precluding denture management and performing oral hygiene measures is advised.

Keywords: dental care for aged, dental implants, geriatric dentistry, peri-implant bone loss, peri-implantitis