Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1, Kitasenzoku, Ohta-ku, Tokyo, 145-8515, Japan.
Maxillofacial Prosthetics Clinic, Tohoku University Hospital, 1-1, Seiryomachi Aoba-ku, Sendai-shi, Miyagi, 980-8574, Japan.
BMC Oral Health. 2020 Nov 25;20(1):335. doi: 10.1186/s12903-020-01279-0.
Self-care and professional care of implants may prove difficult for elderly people who require nursing care. However, the actual state of care and problems remains unknown. In this study, we investigated the actual state of implant problems in elderly people living in their own home or in a nursing home who received visiting dental treatment.
We mailed questionnaire survey forms to 2339 representatives or specialists who were members of the Japanese Society of Oral Implantology, the Japanese Society of Gerodontology or the Japan Prosthodontic Society. We narrowed down the respondents to those who provided visiting dental treatment, and analyzed the actual state of implants observed during visiting dental treatment (type, care, problems, countermeasures, etc.).
Of the 924 dentists who responded to the questionnaire survey, 291 (22%) provided visiting dental treatment. While the majority of implant types encountered in the previous 12 months were root-form implants, there were still a certain number of blade and subperiosteal implants. Daily implant care involved mostly cleaning with a toothbrush + auxiliary tools. The most frequent implant problems encountered in the past were difficulty in cleaning and peri-implantitis. Medication and antiphlogistic treatment were most frequently adopted as countermeasures to implant problems, followed by observation. When we classified the results into those for the dentists who provided implant treatment and those for the dentists who did not, we found that many of the dentists who did not provide implant treatment opted for observation or medication, while those who provided implant treatment also implemented removal of superstructure, retightening of screws, repair and so forth.
We found that many of the implant troubles encountered by dentists who provided visiting dental care were difficulty in cleaning or peri-implantitis, and that the actions taken against these troubles varied depending on the experience of the dentist performing the implant treatment. Our study also revealed that dentists who provide visiting dental care need to acquire knowledge and skills of implant treatment, to have actions prepared in case they encounter such cases, or to closely coordinate with dentists who specialize in implants.
需要护理的老年人在自我护理和专业护理植入物方面可能会遇到困难。然而,实际的护理状况和问题仍不清楚。在这项研究中,我们调查了在自己家中或养老院接受上门牙科治疗的老年人中植入物问题的实际状况。
我们向日本口腔种植学会、日本老年牙科学会和日本修复学会的 2339 名代表或专家邮寄了问卷调查表。我们将回复者缩小到那些提供上门牙科治疗的人,并分析了在上门牙科治疗中观察到的植入物的实际状况(类型、护理、问题、对策等)。
在对问卷调查做出回应的 924 名牙医中,有 291 名(22%)提供了上门牙科治疗。虽然在过去 12 个月中遇到的大多数植入物类型是根形植入物,但仍有一定数量的叶片和骨膜下植入物。日常植入物护理大多涉及使用牙刷+辅助工具清洁。过去遇到的最常见的植入物问题是清洁困难和种植体周围炎。药物和抗炎治疗是最常采用的植入物问题对策,其次是观察。当我们将结果分为提供植入物治疗的牙医和不提供植入物治疗的牙医进行分类时,我们发现许多不提供植入物治疗的牙医选择观察或药物治疗,而提供植入物治疗的牙医则选择拆除上部结构、重新拧紧螺丝、修复等。
我们发现,上门牙科护理牙医遇到的许多植入物问题是清洁困难或种植体周围炎,针对这些问题采取的措施因进行植入物治疗的牙医的经验而异。我们的研究还表明,提供上门牙科护理的牙医需要获得植入物治疗的知识和技能,为遇到此类病例做好准备,或与专门从事植入物的牙医密切协调。