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Dental implants have high survival rates in patients older than 65 years
JADA+ CONTENT
This review does not in any way substitute for professional advice and should not be regarded as clinical guidance. As always, any evidence should be carefully considered by clinician and patient to ensure that in their views, all potentially desirable consequences outweigh all potentially undesirable consequences.
JADA+ CLINICAL SCANS
Romina Brignardello-Petersen, DDS, MSc, PhD
DENTAL IMPLANTS HAVE HIGH SURVIVAL RATES IN PATIENTS OLDER THAN 65 YEARS
Srinivasan M, Meyer S, Mombelli A, Müller F. Dental implants in the elderly population: a systematic review and meta-analysis [published online ahead of print June 7, 2016]. Clin Oral Implants Res. http://dx.doi. org/10.1111/clr.12898. Key words. Implantology; geriatrics; edentulous jaws; elderly patients; implant survival; systematic review. Clinical relevance. As the population ages, more elderly patients are replacing their missing teeth. Dental implants have had good outcomes in younger patients, and clinicians and older patients may consider them to be an option. Knowing the prognosis of dental implants in patients older than 65 years is helpful when making treatment plans for older patients. Study summary. The authors of this systematic review (SR) assessed the survival, peri-implant bone loss, and complications of dental implants in patients older than 65 years. The authors searched 4 main electronic databases and the gray literature for clinical studies and included 11 studies that met their criteria. They conducted a meta-analysis of the studies and found that the implant survival rate was 97.7%* at 1 year and decreased slightly to 91.2%y after 10 years. They did not conduct a meta-analysis for other outcomes but found that mean bone loss ranged from
0.1 to 0.3 millimeters at 1 year and increased to 0.7 to 1.5 mm at 10 years. Complications were infrequent; the most common was bone loss.z Strengths and limitations. The authors conducted a comprehensive search, ensuring that all the relevant evidence was included. There was no evidence of publication bias. They conducted a meta-analysis only for implant survival; however, the results for it and the peri-implant bone loss were consistent across studies. These features increased our confidence in the results. On the other hand, when describing their review, the authors showed a lack of clarity regarding some relevant concepts. For example, they failed to recognize the type of study design for the primary studies they included, and their objective and results were inconsistent. They also failed to recognize that a risk of bias assessment for the included studies was necessary, leaving us with fewer tools to judge whether the evidence was trustworthy. However, because the reported survival rate of dental implants was high, it was unlikely that these shortcomings would have resulted in a bias large enough to change our conclusions with regard to the prognosis of implants in patients older than 65 years. n http://dx.doi.org/10.1016/j.adaj.2016.11.028 Copyright ª 2017 American Dental Association. All rights reserved.
Address correspondence to Dr. Brignardello-Petersen at email rominabp@ gmail.com. Disclosure. Dr. Brignardello-Petersen did not report any disclosures. * 95% confidence interval (CI), 95.8%-98.8%; n ¼ 6 studies; 511 patients. y 95% CI, 83.4%-95.6%; n ¼ 3 studies; 101 patients. z 7 cases across all included studies
JADA
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http://jada.ada.org
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2016 e1
This review does not in any way substitute for professional advice and should not be regarded as clinical guidance. As always, any evidence should be carefully considered by clinician and patient to ensure that in their views, all potentially desirable consequences outweigh all potentially undesirable consequences.
JADA+ CLINICAL SCANS
Romina Brignardello-Petersen, DDS, MSc, PhD
DENTAL IMPLANTS HAVE HIGH SURVIVAL RATES IN PATIENTS OLDER THAN 65 YEARS
Srinivasan M, Meyer S, Mombelli A, Müller F. Dental implants in the elderly population: a systematic review and meta-analysis [published online ahead of print June 7, 2016]. Clin Oral Implants Res. http://dx.doi. org/10.1111/clr.12898. Key words. Implantology; geriatrics; edentulous jaws; elderly patients; implant survival; systematic review. Clinical relevance. As the population ages, more elderly patients are replacing their missing teeth. Dental implants have had good outcomes in younger patients, and clinicians and older patients may consider them to be an option. Knowing the prognosis of dental implants in patients older than 65 years is helpful when making treatment plans for older patients. Study summary. The authors of this systematic review (SR) assessed the survival, peri-implant bone loss, and complications of dental implants in patients older than 65 years. The authors searched 4 main electronic databases and the gray literature for clinical studies and included 11 studies that met their criteria. They conducted a meta-analysis of the studies and found that the implant survival rate was 97.7%* at 1 year and decreased slightly to 91.2%y after 10 years. They did not conduct a meta-analysis for other outcomes but found that mean bone loss ranged from
0.1 to 0.3 millimeters at 1 year and increased to 0.7 to 1.5 mm at 10 years. Complications were infrequent; the most common was bone loss.z Strengths and limitations. The authors conducted a comprehensive search, ensuring that all the relevant evidence was included. There was no evidence of publication bias. They conducted a meta-analysis only for implant survival; however, the results for it and the peri-implant bone loss were consistent across studies. These features increased our confidence in the results. On the other hand, when describing their review, the authors showed a lack of clarity regarding some relevant concepts. For example, they failed to recognize the type of study design for the primary studies they included, and their objective and results were inconsistent. They also failed to recognize that a risk of bias assessment for the included studies was necessary, leaving us with fewer tools to judge whether the evidence was trustworthy. However, because the reported survival rate of dental implants was high, it was unlikely that these shortcomings would have resulted in a bias large enough to change our conclusions with regard to the prognosis of implants in patients older than 65 years. n http://dx.doi.org/10.1016/j.adaj.2016.11.028 Copyright ª 2017 American Dental Association. All rights reserved.
Address correspondence to Dr. Brignardello-Petersen at email rominabp@ gmail.com. Disclosure. Dr. Brignardello-Petersen did not report any disclosures. * 95% confidence interval (CI), 95.8%-98.8%; n ¼ 6 studies; 511 patients. y 95% CI, 83.4%-95.6%; n ¼ 3 studies; 101 patients. z 7 cases across all included studies
JADA
( )
- -
http://jada.ada.org
-
2016 e1