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Volume 32 , Issue 2
March/April 2017

Pages 415422

Short Dental Implants Retaining Two-Implant Mandibular Overdentures in Very Old, Dependent Patients: Radiologic and Clinical Observation Up to 5 Years

Sabrina Maniewicz, Med Dent/Ramona Buser, Dr Med Dent/Elena Duvernay, Dr Med Dent/Lydia Vazquez, Dr Med Dent Habil, PhD/Angelica Loup, Dr Med Dent/Thomas V. Perneger, Dr Med, PhD/Martin Schimmel, Dr Med Dent Habil, MAS/Frauke Müller, Dr Med Dent Habil

PMID: 28291859
DOI: 10.11607/jomi.5361

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.

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