Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta-analysis

Clin Oral Implants Res. 2018 Oct:29 Suppl 16:311-330. doi: 10.1111/clr.13288.

Abstract

Objectives: his review evaluated implant survival in geriatric patients (≥75 years) and/or the impact of systemic medical conditions.

Materials and methods: Systematic literature searches were performed to identify studies reporting on geriatric subjects with dental implants and on implant patients who had any of the seven most common systematic conditions among geriatric patients. Meta-analyses were performed on the postloading implant survival rates. The impact of systemic medical conditions and their respective treatment was qualitatively analyzed.

Results: A total of 6,893 studies were identified; of those, 60 studies were included. The fixed-effects model revealed an overall implant survival of 97.3% (95% CI: 94.3, 98.7; studies = 7) and 96.1% (95% CI: 87.3, 98.9; studies = 3), for 1 and 5 years, respectively. In patients with cardiovascular disease, implant survival may be similar or higher compared to healthy patients. High implant survival rates were reported for patients with Parkinson's disease or diabetes mellitus type II. In patients with cancer, implant survival is negatively affected, namely by radiotherapy. Patients with bone metastases receiving high-dose antiresorptive therapy (ART) carry a high risk for complications after implant surgery. Implant survival was reported to be high in patients receiving low-dose ART for treatment of osteoporosis. No evidence was found on implant survival in patients with dementia, respiratory diseases, liver cirrhosis, or osteoarthritis.

Conclusions: Implant prostheses in geriatric subjects are a predictable treatment option with a very high rate of implant survival. The functional and psychosocial benefits of such intervention should outweigh the associated risks to common medical conditions.

Keywords: Alzheimer's disease; Parkinson's disease; aging; bisphosphonates; cancer; cardiovascular disease; chronic obstructive pulmonary disease; cirrhosis of the liver; dementia; dental implants; depression; diabetes mellitus; geriatric; hypertensive heart disease; hyposalivation; ischemic heart disease; lower respiratory infections; medication-related osteonecrosis of the jaw; meta-analysis; neurocognitive impairment; osteoarthritis; radiotherapy; respiratory diseases; stroke; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Age Factors*
  • Aged
  • Aged, 80 and over
  • Alveolar Bone Loss
  • Bone Density Conservation Agents / adverse effects
  • Cardiovascular Diseases / complications
  • Dementia / complications
  • Dental Implantation, Endosseous*
  • Dental Implants*
  • Dental Restoration Failure*
  • Diabetes Complications
  • Diabetes Mellitus, Type 2 / complications
  • Humans
  • Lung Diseases / complications
  • Neoplasm Metastasis
  • Neoplasms / complications
  • Osteoporosis / complications
  • Osteoporosis / therapy
  • Parkinson Disease / complications
  • Radiotherapy / adverse effects
  • Risk Factors
  • Survival Analysis
  • Xerostomia / complications

Substances

  • Bone Density Conservation Agents
  • Dental Implants