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Bogner MS, Chambas V, Nicolas E, Faulks D, Hennequin M. Implant-supported prostheses in patients with special needs: A systematic literature review of protocols and outcomes. J Prosthet Dent 2023:S0022-3913(23)00628-5. [PMID: 37880026 DOI: 10.1016/j.prosdent.2023.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/27/2023]
Abstract
STATEMENT OF PROBLEM Implant-supported prostheses for individuals with special needs have been considered high-risk because of the prevalence of poor oral hygiene and parafunction in this population; however, systematic evidence on protocols and outcomes is scarce. PURPOSE The purpose of this systematic review was to summarize implant procedures and outcomes for the special needs population. MATERIAL AND METHODS A systematic literature review was conducted using PubMed, Embase, and Scopus databases in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodological framework. Data collected included patient information, location and number of implants, surgical and prosthetic procedures, behavior support techniques, postoperative follow-up, complications, and criteria for outcome assessment. Survival rates were pooled for quantitative analysis, and a separate analysis pooling data from groups of special needs patients that present similar risks was undertaken. RESULTS The qualitative analysis included 79 studies involving 759 patients and 2269 implants. The quantitative analysis included 65 studies concerning 666 patients with special needs and 1886 implants. The overall weighted implant survival rate was 95.4%, with a mean follow-up duration of 40.7 ±29.5 months. CONCLUSIONS In individuals with special needs considered suitable for implant-supported prostheses by their clinician, implant survival rates were similar to those reported in the general population. (J Prosthet Dent xxxx;xxx:xxx-xxx).
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Affiliation(s)
- Marie-Sophie Bogner
- Specialist, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France.
| | - Vivien Chambas
- Specialist, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and Private practice, Clermont-Ferrand, France
| | - Emmanuel Nicolas
- Professor, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Denise Faulks
- Specialist Consultant, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, F-63000 Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Martine Hennequin
- Professor, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
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Baus-Domínguez M, Gómez-Díaz R, Torres-Lagares D, Gutiérrez-Pérez JL, Machuca-Portillo G, Serrera-Figallo MÁ. Retrospective Case-Control Study Genes Related to Bone Metabolism That Justify the Condition of Periodontal Disease and Failure of Dental Implants in Patients with down Syndrome. Int J Mol Sci 2023; 24:ijms24097723. [PMID: 37175429 PMCID: PMC10178122 DOI: 10.3390/ijms24097723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Down syndrome patients show success rates in dental implants much lower than those observed in the general population. This retrospective case-control study aimed to identify possible genes that are related to the regulation of inflammatory responses and bone metabolism related to periimplantitis and implant loss, as well as genes related to bone quality. This process involved using the functional analysis of the gene expression software Transcriptome Analysis Console (TAC version 4.0 Applied BiosystemsTM, Thermo Fisher Scientific, Waltham, MA, USA) and a search for possible candidate genes involved. The focus was placed on the 93 genes related to periodontitis, periimplantitis, bone loss, implant loss, and genes related to bone quality and regulators underlying the establishment and maintenance of osseointegration. Five genes showed statistically significant results (p < 0.05) in our comparison. Four of them, IL1B (p = 0.023), IL1RN (p = 0.048), BGLAP (p = 0.0372) and PTK2 (p = 0.0075) were down-regulated in the periodontal disease and implant rejection group, and only one was overexpressed: FOXO1A (p = 0.0552). The genes with statistically significant alterations described in this article determine that the group of Down syndrome patients with periodontal disease and implant failure is a group of patients genetically susceptible to suffering from both conditions together.
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Affiliation(s)
- María Baus-Domínguez
- Department of Dentistry, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | | | - Daniel Torres-Lagares
- Department of Dentistry, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Jose-Luis Gutiérrez-Pérez
- Oral and Maxillofacial Unit, Virgen del Rocio Hospital, 41013 Seville, Spain
- Oral Surgery Department, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
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Comparin LL, Filho RP, Deliberador T, de Souza G, Tatim T, Müller PR, Moreno R. Sinus lift technique and dental implants for rehabilitation for a Down syndrome patient with tomographic 3-years follow-up. SPECIAL CARE IN DENTISTRY 2022; 42:524-530. [PMID: 35037271 DOI: 10.1111/scd.12697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/18/2021] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
Down Syndrome or trisomy 21 (T21) is a genetic condition caused by the presence of an extra chromosome in pair 21 and is related to a high prevalence of agenesis of permanent teeth and periodontal alterations that may be associated to the loss of permanent teeth at early ages. With the increase in life expectancy of people with T21 in the last decades, it is necessary to expand the knowledge to offer possibilities of treatment with dental implants, aiming to serve this aging population. AIMS The aim of this article is to report a surgical procedure of sinus lift to enable the installation of dental implants in the posterior region of the maxilla. METHODS AND RESULTS A 50 year-old patient with T21 was rehabilitated with implants, simultaneously with sinus lift surgery, by the lateral window technique, using xenogenous bone graft and fibrin-rich plasma. After 1 year, the patient was rehabilitated with prosthetics on implants. CONCLUSION The feasibility of this technique in patients with Down syndrome could be observed, after 3 years of follow up, with favorable clinical results.
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Affiliation(s)
- Lizandra Lopes Comparin
- Latin American Institute of Dental Research and Education-ILAPEO, Curitiba, State of Paraná, Brazil
| | - Ricardo Pasquini Filho
- Latin American Institute of Dental Research and Education-ILAPEO, Curitiba, State of Paraná, Brazil
| | - Tatiana Deliberador
- Latin American Institute of Dental Research and Education-ILAPEO, Curitiba, State of Paraná, Brazil
| | - Gizelli de Souza
- Latin American Institute of Dental Research and Education-ILAPEO, Curitiba, State of Paraná, Brazil
| | - Thiago Tatim
- Latin American Institute of Dental Research and Education-ILAPEO, Curitiba, State of Paraná, Brazil
| | | | - Rubens Moreno
- Latin American Institute of Dental Research and Education-ILAPEO, Curitiba, State of Paraná, Brazil
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Sales PHDH, Barros AWP, de Lima FJC, Carvalho ADAT, Leão JC. Is Down syndrome a risk factor or contraindication for dental implants? A systematic review. J Prosthet Dent 2021; 129:531-537. [PMID: 34332773 DOI: 10.1016/j.prosdent.2021.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Whether oral rehabilitation with dental implants in patients with Down syndrome leads to an increased complication rate is unclear. PURPOSE The purpose of this systematic review was to determine the effectiveness of dental implants placed in patients with Down syndrome and whether the condition is a risk factor or contraindication for dental implant placement. MATERIAL AND METHODS Searches were conducted in 6 databases, including the non-peer-reviewed literature, up to February 2021 by 2 independent reviewers according to established inclusion and exclusion criteria to answer this question: Is Down syndrome a risk factor or contraindication for oral rehabilitation with dental implants? RESULTS A total of 655 studies were initially found in the databases. Five were included in this systematic review, all of which were observational studies. A total of 50 patients with 186 implants were evaluated, with a reported effectiveness of 79.1%. The risk of bias assessment determined that 3 of the 5 studies had a high risk of bias. CONCLUSIONS Treatment with dental implants in patients with Down syndrome is a suitable option, but more complications are to be expected than with patients without this condition. Controlled studies with better methodological design and less risk of bias should be developed to improve the scientific evidence for the treatment of these patients.
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Affiliation(s)
- Pedro Henrique da Hora Sales
- PhD student, Postgraduate Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil.
| | - Ana Waleska Pessoa Barros
- MSc student, Postgraduate Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Fernando José Camello de Lima
- Adjunct Professor, Institute of Health and Biological Sciences, Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | | | - Jair Carneiro Leão
- Full Professor, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Satir S. Determination of mandibular morphology in a TURKISH population with Down syndrome using panoramic radiography. BMC Oral Health 2019; 19:36. [PMID: 30808330 PMCID: PMC6390525 DOI: 10.1186/s12903-019-0722-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/30/2019] [Indexed: 11/23/2022] Open
Abstract
Background Down syndrome (DS) is by far the most common known chromosomal disorder. Some characteristic features of DS are generalised growth deficiency, craniofacial abnormalities such as mandibular prognathism and underdevelopment of the midfacial region, dental abnormalities such as taurodontism and hypodontia. Individuals with DS have an increased prevalence of periodontal disease compared with age-matched control patients. The aim of the present study is to determine the morphologic features of the mandible among individuals with DS. Methods Thirty-four DS patients and thirty four age- and gender-matched control subjects underwent panoramic radiography, which included measurement of the mandibular canal (MC), the mandibular foramen (MF), the mandibular ramus (MR), the distance from the MC to the mandibular lower border (C-MLB), and the distance between the MC and the alveolar crest upper limit (C-AUL). Patients were separated into two groups based on age: < 15 (n = 15) and ≥ 15 (n = 19). In order to determine whether the MF, MR, MC, C-AUL, and C-MLB scores differed according to the groups (DS and control), one-way multivariate analysis of covariance (MANCOVA) was applied in which gender and age were taken as covariates. Results When the main effect according to the group was examined separately according to each measurement, the MF in the DS group was high with a moderate effect (F = 9207; p = 0.003). MR (F = 40,518; p < 0.001), MC (F = 23,747; p < 0.001), and C-AUL (F = 58,571; p < 0.001) in the DS group were lower with a larger effect. C-MLB did not significantly differ between the groups, and the effect size was quite low (p > 0.05). Conclusions Mandibular canal morphology may exhibit anatomical variations in DS. The alveolar bone level may differ from non-DS due to growth development retardation and/or periodontal diseases.
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Affiliation(s)
- Samed Satir
- Akdeniz University, Faculty of Dentistry, Oral and Maxillofacial Radiology, Akdeniz University Dumlupinar Boulevard 07058 Campus Antalya, Antalya, Turkey.
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Hillebrecht AL, Hrasky V, Anten C, Wiegand A. Changes in the oral health-related quality of life in adult patients with intellectual disabilities after dental treatment under general anesthesia. Clin Oral Investig 2019; 23:3895-3903. [PMID: 30707300 DOI: 10.1007/s00784-019-02820-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 01/16/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to assess self- and proxy-rated changes in the oral health-related quality of life (OHRQoL) in adult patients with intellectual disabilities after dental treatment in general anesthesia. METHODS The OHRQoL in 52 adult patients with intellectual and developmental disabilities was assessed prior to dental treatment in general anesthesia (t0), 2 to 3 (t1) and 12 weeks (t2) postoperatively. Therefore, patients and primary cargivers were surveyed using either the 5-item short form of the Oral Health Impact Profile translated into easy language (OHIP-G5-easy, self-rating, n = 27) or the 14-item short form of the Oral Health Impact Profile (OHIP-G14, proxy-rating, n = 51), respectively. OHIP-G5-easy and OHIP-G14 summary scores were statistically analyzed with non-parametric mixed effects models and spearman correlation (p < 0.05). Additionally, the effect of demographic, anamnestic, oral health and treatment factors on QHRQoL or on changes of OHRQoL were analyzed using univariate and multivariate ordinal logistic regressions (p < 0.05). RESULTS Self- (t0: 5.8 ± 4.6, t1: 4.3 ± 5.9, t2: 2.0 ± 3.9) and proxy-ratings (t0: 18.8 ± 11.6, t1: 10.1 ± 11.2, t2: 2.7 ± 5.3) revealed a significant improvement of OHRQoL after dental treatment in general anesthesia. Data showed a moderate correlation (p < 0.001, rSp = 0.43). OHRQoL at baseline was affected by the etiology of cognitive impairment and by the periodontal status (OHIP-G14). Improvement of OHRQoL was associated with the etiology of cognitive impairment (OHIP-G14) and the extent of dental treatment (OHIP-G5-easy). CONCLUSION Self- and proxy-ratings revealed a significant improvement of OHRQoL in patients with intellectual disabilities after dental treatment in general anesthesia. CLINICAL RELEVANCE Assessment of OHRQoL promotes patient-centred care of adults with intellectual disabilities.
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Affiliation(s)
- Anna-Lena Hillebrecht
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany
| | - Valentina Hrasky
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany
| | - Christoph Anten
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany.
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Najeeb S, Khurshid Z, Siddiqui F, Zohaib S, Zafar MS. Outcomes of Dental Implant Therapy in Patients With Down Syndrome: A Systematic Review. J Evid Based Dent Pract 2017; 17:317-323. [PMID: 29197433 DOI: 10.1016/j.jebdp.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Patients with Down syndrome (DS) require an earlier and more frequent tooth replacement than rest of the population. The objective of this systematic review is to critically analyze and summarize studies to ascertain the outcomes and survival of dental implants placed in jaws of DS patients. METHODS Using the key words "dental implants," "Down syndrome," and "prosthodontics," an electronic search was conducted via PubMed/MEDLINE, ISI Web of Science, Google Scholar, Embase, and Central Register of Controlled Trials (CENTRAL) databases by 2 authors, S.N. and Z.K., independently. Retrieved studies were screened against the predefined exclusion and inclusion criteria. To estimate the risk of bias, quality assessment of included studies was carried using the 'Case Reports (CARE) guidelines'. RESULTS Primary search resulted in 156 studies. Eight studies met the inclusion criteria and reporting a total of 81 dental implants placed in 36 DS patients. The type of implant loading ranged from immediate to a delay of 1 year after placement of the implant. Implant diameter ranged from 3.3 to 4.5 mm, and height ranged from 8.5 to 18 mm. The follow-up ranged from 1 to 6 years. Of 81 implants placed, 21 implants (26%) were reported as failed. CONCLUSIONS Patients with DS have a higher risk of implant failure. However, the reason for the failure is not very well understood. Although case reports and case series suggest that implant survival is diminished in DS patients, large-scale randomized controlled trials are required to determine the exact mechanism associated with risks of implant failure.
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Affiliation(s)
| | - Zohaib Khurshid
- Department of Prosthodontics and Implantology, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Fahad Siddiqui
- Department of Pediatric Dentistry, Rutgers University, New Brunswick, NJ, USA
| | - Sana Zohaib
- School of Biomedical Engineering, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan.
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