Implant failures and age at the time of surgery: A retrospective study on implant treatments in 4585 edentulous jaws

Oral Health Differences Between Middle-Aged and Older Adults in South Korea

INTRODUCTION AND AIMS

The oral health characteristics of middle-aged and older adults exhibit variations. This study identifies the various factors associated with oral health among middle-aged and older adults through a subgroup analysis by age group of data representative of the South Korean population.

METHODS

We examined influencing factors: demographic, socioeconomic, dental, physical attributes, psychological, and mental attributes. Oral health was assessed using the Geriatric Oral Health Assessment Index. The participants were divided into two groups: those under 65 years of age (middle-aged) and those over 65 years of age (older adults). We used multiple linear regression analysis and dominance analysis to determine the dominant factors associated with oral health.

RESULTS

A total of 6369 participants were aged 69.2 ± 9.8 years on average, and 57.5% were women. Dominance analysis revealed that lower educational levels and activity difficulty caused by diseases were significantly associated with both groups. Moreover, depressive symptoms were the foremost adverse factor linked to oral health in the middle-aged (P < .001, standardized beta [β] = -4.30, general dominance index [GDI] = 19.00) and older (P < .001, β = -0.30, GDI = 10.70) adults. The number of teeth exhibited the most positive association with oral health in both middle-aged (P < .001, β = 0.20, GDI = 5.30) and older (P < .001, β = 0.23, GDI = 7.40) adults. However, cognitive function, dental visits, body mass index, severe pain, functional limitations, and cognitive function exhibited distinct patterns between the age groups.

CONCLUSION

Depressive symptoms and the number of teeth significantly influence oral health in middle-aged and older adults, though the impact varies by age. These findings stress the importance of tailored strategies considering age-specific attributes for effective oral health improvement.

CLINICAL RELEVANCE

Enhancing oral health requires healthcare providers to prioritize monitoring age-specific risk factors. Further, educational plans should highlight the importance of preventive oral care and regular dental visits.

Implant Survival in Immediately Loaded Full-Arch Rehabilitations Following an Anatomical Classification System-A Retrospective Study in 1200 Edentulous Jaws

This retrospective study analyzed implant survival of immediate implant-supported fixed complete denture (IFCD) treatment options (TOs) based on the level of alveolar atrophy (CC). Records of 882 patients receiving a total of 6042 implants at one private referral clinic between 2004 and 2020 were considered. The mean follow-up period was 3.8 ± 2.7 years. Cumulative implant survival rates (CSRs) were analyzed as a function of CCs and TOs according to Mantel-Haenszel and Mantel-Cox. Hazard risk ratios for implant loss were compared using Cox regression. Confounding factors were identified using mixed Cox regression models. The 2- and 5-year CSRs were 98.2% and 97.9%, respectively. Maxillary 2- and 5-year CSRs were lower (97.7% and 97.3%) compared to mandibular CSRs (99.8% and 98.6%) (p = 0.030 and 0.0020, respectively). The CC did not influence CSRs of IFCDs in the mandible (p = 0.1483 and 0.3014, respectively) but only in the maxilla (p = 0.0147 and 0.0111), where CSRs decreased with increasing atrophy. TOs did not statistically differ in terms of survival rate for a given level of alveolar atrophy. The adaption of IFCD treatments to the level of atrophy and patient-specific risk factors can result in high CSRs, even at different levels of bone atrophy.

Mortality in Edentulous Patients: A Registry-Based Cohort Study in Sweden Comparing 8463 Patients Treated with Removable Dentures or Implant-Supported Dental Prostheses

Objectives

The purpose of this study was to investigate if edentulism is associated with all-cause mortality. The aims were to analyze the association between age, socioeconomic factors, and mortality in edentulous patients treated with either removable dentures or implant-supported prostheses.

Methods

All patients who became edentulous according to the Swedish Social Insurance Agency (SSIA) between 2009 and 2013 (N  = 8463) were analyzed regarding prosthetic treatment, age, gender, and socioeconomic status. The patients were divided into two groups, depending on whether they were treated with dental implants (implant group; IG) or with conventional removable dentures (denture group; DG). Data on mortality for all included individuals were obtained from the Swedish National Cause of Death Register and compared to a reference population. Cumulative survival rates were calculated, and a multivariable regression analysis for the included variables was performed.

Results

Between 2009 and 2018, 2192 of the patients (25.9%) were treated with implant-supported dental prostheses (IG) and 6271 patients (74.1%) were treated with removable dentures without support of dental implants (DG). Altogether 2526 patients (30%) died until December 31, 2019, and the overall mortality was significantly higher for the DG compared to the IG during follow-up (p < 0.001). Younger edentulous patients (≤59 years) presented a higher mortality than the reference population, while implant patients over 79 years of age demonstrated a lower mortality. The final results from the multivariable logistic analysis showed that lower equalized disposable income (EDI) and the choice of conventional removable dentures are the most important factors for increased patient mortality (p < 0.001).

Conclusions

Edentulous patients have an overall higher mortality compared to a reference population. Low socioeconomic status increases all-cause mortality. Individuals treated with dental implants show statistically significant lower 10-year mortality compared to patients treated with conventional removable dentures, regardless of socioeconomic status.

On marginal bone level changes around dental implants

BACKGROUND

Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant, despite the fact that their significance for the long-term survival of the implant has never been properly assessed.

PURPOSE

To challenge the assumption that the natural course of peri-implant bone loss is the loss of the implant.

MATERIALS AND METHODS

This article is a narrative review on reasons and interpretations of marginal bone level changes around dental implants.

RESULTS AND CONCLUSIONS

Different views regarding the pattern and progression of marginal bone loss depending on dental specialties have been identified. However, the present finding of a negative correlation between an increasing cumulative marginal bone loss and a decreasing risk of implant failures over time indicates that peri-implant marginal bone loss does not necessarily represent a condition of disease. Reduction of marginal bone levels may be observed in a majority of patients during follow-up time, with only a minority of those patients losing implants and implant-supported prostheses in the long term. Bone level changes seem often to occur as a consequence of physiological processes and/or as an adaptation to altered external as well as host response factors. Periodical radiological assessments of implant-restorations remain a valid diagnostic tool for the detection of potential implant fractures, loss of osseointegration, screws working loose and for the detection of the few cases with advanced, continuously progressing marginal bone loss during time. The detection of peri-implant marginal bone loss at one time point should not be immediately considered as a sign of ongoing pathology and of an increased risk of future loss of the implant in question.

Comparing factors affecting dental-implant loss between age groups: A retrospective cohort study

BACKGROUND

There is a growing interest in factors leading to implant failure in older people as the population aged 65 years or older continues to expand.

PURPOSE

We sought to identify differences of results in the implant survival rate and the influence of certain factors on implant failure in the older (≥65 years) and younger (<65 years) patients.

MATERIALS AND METHODS

Patients who underwent their first dental-implant surgery between July 2008 and June 2018 were included. Data on age, sex, smoking habits, medical conditions, implant location, implant size, and the presence and type of bone graft and membrane were collected and analyzed according to age group. Moreover, cumulative survival rates of implants (by Kaplan-Meier analysis) and hazard ratios (HR) of each factor (using Cox regression analysis with shared frailty) in each group were assessed and results compared between groups.

RESULTS

A total of 628 implants in 308 patients and 1904 implants in 987 patients in the older and younger groups, respectively, were assessed, with failure rates of 3.9% and 3.4%. Per Kaplan-Meier analysis, the 11-year patient-level cumulative survival rate of implant treatment was 95.3% (95% CI: 0.91-0.97) in the older and 93.9% (95% CI: 0.88-0.97) in the younger group. The HR for implant failure of the variables, except diameter of dental implants, were not statistically significant in both groups.

CONCLUSION

The outcomes of implant treatment were not considerably different between the age groups.

[Clinical analysis of the short-term and long-term results of the implant-supported Trefoil dental rehabilitation in Russia]

THE AIM OF THE STUDY

Was to presents the first clinical medium-term (18 months) results of implant-supported rehabilitation using this method in Russia, with the special attention paid to the assessment of the patient's quality of life on the GOHAI scale.

MATERIALS AND METHODS

The authors performed a clinical and paraclinical examination of 29 patients (20 women and 9 men). The age of the patients ranged from 47 to 88 (average value - 65.45±9.7). We performed a retrospective analysis of all patients operated from June 2017 till March 2019. The patients filled in GOHAI questionnaires about their state of health and quality of life (before treatment and 6 weeks post-surgery). Patients with one or more anterior teeth present as well as fully edentulous mandibles were included in the study. The antagonist teeth could be presented as complete dentures, natural teeth, or implant-supported fixed restorations. All patients received three Trefoil implants (Nobel Biocare AB) inserted with a torque of at least 35 Ncm. The Trefoil bar (Nobel Biocare AB) was used as the framework of the Trefoil bioengineering structure. Statistical processing of the results was performed using the SPSS 23 software. The t-test for dependent samples was used to compare the results of GOHAI surveys before and after the operation and the following statistical hypotheses were suggested: H0 - the results of the GOHAI survey before the operation do not differ from the results of the GOHAI survey after the operation; H1 - GOHAI pre-op survey results are different from GOHAI post-op survey results. A comparison was made between the GOHAI results before and after surgery in male and female patients using the t-test for independent samples.

RESULTS

29 patients included in this (20 females and 9 males) with the mean age of 65 (range:47-88). The average time of operation (surgical operation, prosthetic stage including dental lab work) the Trefoil technique was 6.18 ± 0.87 hours. With the presence of teeth in the mandible, the operation took longer by an average of 45 minutes. Patients were followed for 15±6 months. No chipping of artificial teeth or fractures of the veneering was observed. The survival rate of restorations was 100%. The implant survival rate was 98.85%. The results of the GOHAI survey after surgery show a significant difference from the results of the pre-op survey. If we analyze the average values for the sample, it can be argued that the average result for the GOHAI survey before the operation (29.86) is significantly lower than the average one for the GOHAI survey after the operation (54.93).

CONCLUSION

Preliminary medium-term results of the Trefoil concept for implant-supported rehabilitation of the mandible indicate high patient satisfaction results after 6-18 months of follow-up. It requires a further comprehensive study to obtain data with more patients and over a longer follow-up period.