Implants for the aged patient: biological, clinical and sociological considerations

Bartold, P. Mark; Ivanovski, Sašo; Darby, Ivan

doi:10.1111/prd.12133

Cited by 32 publications

(33 citation statements)

References 132 publications

(208 reference statements)

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“…Meta‐analysis of the regression coefficients indicated a relationship between % graft resorption and patient age ( p < 0.01; Supporting Information Appendix c). Age has been controversially discussed as a factor influencing implant success (Bartold, Ivanovski, & Darby, ; Ikebe, Wada, Kagawa, & Maeda, ). Presumably, older patients may exhibit poorer local bone condition, require longer healing periods and display more systematic diseases related to healing potential in general.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta‐analysis

Naenni

Lim

Papageorgiou

et al. 2019

J Clinic Periodontology

119

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Aim The aim of the current systematic review was to critically appraise evidence from randomized and prospective non‐randomized comparative clinical trials about the efficacy of lateral bone augmentation prior to implant placement and their outcome regarding bone width gain. Materials and Methods Eight databases were searched until May 2018 for randomized and prospective non‐randomized comparative trials on lateral bone augmentation prior to implant placement. After elimination of duplicate studies, data extraction and risk‐of‐bias assessment according to the Cochrane guidelines, random‐effects meta‐analyses of mean differences (MD) or relative risks (RR) and their 95% CIs were performed, followed by subgroup, meta‐regression and sensitivity analyses. Results Overall, 25 trials (16 randomized/9 non‐randomized) were identified, which included a total of 553 patients (42.2% male; mean age of 43.9 years). In these included studies and populations, various modalities for primary lateral bone augmentation rendered implant placement feasible. Small discrepancies were found between overall clinical and radiographic gain (pooled gains of 3.45 ± 1.18 mm versus 2.90 ± 0.83 mm, respectively), but were not statistically significant. Bone width gain was significantly inversely associated with baseline bone width (pooled effect: −0.35 mm/mm; 95% CI: −0.63 to −0.07 mm; p = 0.01). Additionally, % graft resorption was associated with patient age (36%/year, 95% CI: −0.62 to −0.11 mm; p = 0.01). The presence of xenograft added to autologous graft led to less resorption compared to autologous graft alone (MD: 1.06 mm; 95% CI: 0.21 to 1.92 mm; p = 0.01). Barrier membrane did not yield significant difference in terms of bone width gain (MD: −0.33 mm; 95% CI: −2.24 to 1.58 mm; p > 0.05) and graft resorption (MD: 0.84 mm; 95% CI: −1.42 to 3.09 mm; p > 0.05). However, the quality of evidence ranged from very low to moderate due to bias and imprecision. Conclusions Initially smaller bone dimensions are associated with favours larger bone width gain, which indicates that a severe lateral bone deficiency can be effectively augmented applying primary lateral bone augmentation. Both Patients’ age and recipient site (maxilla or mandible) seem to influence graft resorption. The addition of a xenograft can be helpful in reducing graft resorption. Existing evidence from randomized and prospective non‐randomized trials on humans indicates that lateral bone augmentation prior to implant placement can successfully increase bone width. There are some indications that patient‐related, site‐related, and technique‐related characteristics might influence the amount of gained bone width, but the quality of evidence is for the most part hampered by the small number of existing studies and methodological limitations that might lead to bias.

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Section: Discussionmentioning

confidence: 99%

Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta‐analysis

Naenni

Lim

Papageorgiou

et al. 2019

J Clinic Periodontology

119

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“…Bartold et al. provide a comprehensive review of dental implant treatment for older adults. Age is not a contraindication to the use of dental implants to replace missing teeth, but aging is associated with delayed healing of nonmineralized and mineralized tissues.…”

Section: Biomarkers and Physiologic Measures Of Aging In The Dunedin mentioning

confidence: 99%

Geriatric periodontology: how the need to care for the aging population can influence the future of the dental profession

Lamster¹

2016

Periodontology 2000

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The world's population is aging, and it has been estimated that by 2050, the number of people 65 years of age and older will reach 1.5 billion. The aging population will be affected by noncommunicable chronic diseases, including diabetes mellitus, cardiovascular disease and cognitive impairment. This important demographic shift includes a reduction in tooth loss/edentulism, particularly in older adults of the developed countries in North America, western Europe and north-east Asia. Therefore, in the future, dental providers will be required to care for an expanded number of older adults who have retained teeth and are medically complex. As the linkage of oral disease and systemic disease has focused on the relationship of periodontitis and noncommunicable chronic diseases, a broad review of 'geriatric periodontology' is both timely and important. This volume of Periodontology 2000 covers a range of subjects under this heading. Included are the demographics of an aging world; the effect of aging on stem cell function in the periodontium; the periodontal microbiota associated with aging; the host response in the periodontium of aging individuals; an analysis of the prevalence of periodontitis in the USA on a national, state-wide and community basis; differentiation of physiologic oral aging from disease; treatment of periodontal disease in older adults; implant therapy for older patients; oral disease and the frailty syndrome; the relationship of tooth loss to longevity and life expectancy; and the relationship of periodontal disease to noncommunicable chronic diseases. Although 'geriatric dentistry' is not a recognized specialty in dentistry, and 'geriatric periodontology' is a descriptive title, the subject of this volume of Periodontology 2000 is critical to the future of clinical dentistry, dental public health and dental research. Any comprehensive focus on older patients can only be accomplished with an emphasis on interprofessional education and practice. If embraced, this shift will allow the dental profession to be more closely aligned with the larger health-care environment, and can improve both oral health and health outcomes for patients seen in the dental office.

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“…Not unexpectedly, individuals of advanced age and geriatric patients also benefit from dental implants that improve their personal quality of life . This is particularly due to oral rehabilitation, which enables normal chewing and as a consequence thereof proper nurturing, facilitating trouble‐free social activities, without disturbing esthetical dental considerations …”

Section: Introductionmentioning

confidence: 99%

Long‐lived murine osteocytes are embodied by craniofacial skeleton in young and old animals whereas they decrease in number in postcranial skeletons at older ages

Stigler¹,

Becker

Kloss³

et al. 2018

Gerodontology

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Tissue-specific conduct of bone ageing is moulded by osteocytic activities, which was found to vary between postcranial and craniofacial skeleton. The latter harbours long-lived osteocytes also in old animals which assures lifelong bone integrity. Preliminary concurring findings from a human cadaver, also presented in this contribution, provided a rationale for recommending the translatability to humans.

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Implants for the aged patient: biological, clinical and sociological considerations

Cited by 32 publications

References 132 publications

Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta‐analysis

Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta‐analysis

Geriatric periodontology: how the need to care for the aging population can influence the future of the dental profession

Long‐lived murine osteocytes are embodied by craniofacial skeleton in young and old animals whereas they decrease in number in postcranial skeletons at older ages

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