Dental treatment under intravenous sedation prolongs longevity of a fixed prosthesis in patients with intellectual disabilities

Aims: This study aimed to assess the longevity of a fixed prosthesis in patients with intellectual disability (ID) and to investigate the risk factors associated with the failure of a prosthesis due to abutment tooth extraction or prosthesis dislodgement or removal.

Methods: We studied past medical records to evaluate the longevity of 315 prostheses that were luted in 76 patients with ID. We calculated the survival rates and assessed 15 variables potentially associated with prosthetic failure using multivariate Cox regression analyses with shared frailty for patients.

Results: Three-quarters of our sample population had severe or profound ID. The maximum observation period was 31.0 years, and the corresponding survival ratio was 32.5%; the survival ratio at 10 years was 59.4%. The use of intravenous sedation significantly influenced the success of the prosthesis, with the hazard ratio (HR) being 0.49 times that of conventional treatment without behavior-altering drug therapy. The most significant risk factor for prosthetic failure was age at placement; the HR for patients aged ≥31 years was 2.82 times that for patients aged ≤ 20 years.

Conclusions: In patients with severe ID, appropriate intravenous sedation was effective in prolonging the longevity of a fixed prosthesis.