Maniewicz Sabrina, Buser Ramona, Duvernay Elena, Vazquez Lydia, Loup Angelica, Perneger Thomas V, Schimmel Martin, Müller Frauke
Int J Oral Maxillofac Implants. 2017 Mar/Apr;32(2):415-422. doi: 10.11607/jomi.5361.
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.
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.
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.
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.
在先前报道的一项随机对照试验背景下，描述依赖日常生活活动（ADL）的高龄患者采用下颌双种植体覆盖义齿（IOD）治疗后的生存率及种植体周围骨丢失情况。
19例患者接受了两枚孔间的士卓曼种植体（常规颈部，直径4.1mm，长度8mm），随后安装Locator附着体，将其原有的下颌传统义齿转变为覆盖义齿。主要观察指标为种植体生存率及通过影像学评估的种植体周围骨丢失。次要观察指标包括种植体周围探诊深度、菌斑指数评分以及种植体松动度。还分析了营养状况（体重指数和血液指标）和认知状态（简易精神状态检查表）。
患者队列包括8名男性和11名女性，平均年龄为85.7±6.6岁。5年时种植体生存率为94.7%，有1例早期和1例晚期种植体失败。种植体周围骨高度的平均每年丢失量为0.17mm（95%置信区间：0.09至0.24；P<.001）。种植体周围探诊深度和菌斑指数评分在最初2年内较低且稳定，此后持续增加。相关性分析表明，认知功能和营养状况下降并非种植体周围骨丢失加速的特定危险因素。
高种植体生存率和可接受的种植体周围健康状况表明，年龄和ADL依赖均不是种植体植入的禁忌证。然而，建议密切监测患者是否存在可能导致义齿管理和口腔卫生措施执行困难的进一步功能衰退情况。
