Fretwurst Tobias, Nelson Katja
Int J Prosthodont. 2021;34:s21-s26. doi: 10.11607/ijp.7000.
To provide an overview of the influence of medical and geriatric factors on implant survival in order to form clinical recommendations for the practitioner.
This narrative literature review was performed to address the following questions: (1) Is age (> 75 years) a risk factor for implant survival?; (2) Is diabetes mellitus a risk factor for implant survival?; and (3) Is antiresorptive therapy a risk factor for implant survival? The PubMed, Web of Knowledge (Thomson Reuters), and Google Scholar databases were searched for systematic reviews and research papers of evidence level II and above that were published up to February 2019 for each topic.
(1) Age > 75 years does not affect implant survival according to short-term follow up (1 to 5 years). However, polypharmacy should be considered in this patient group. (2) Diabetes mellitus is not a risk factor for implant survival in the short term, but there is no information on appropriate perioperative treatment and wound closure. There is little evidence in the literature on the success of bone grafting and progressive loading protocols in diabetic patients. (3) Implant therapy cannot be recommended in patients under high-dose bisphosphonate and antibody therapy. Bone grafting should be avoided under antiresorptive therapy. There are no treatment regimens available for patients with peri-implantitis receiving antiresorptive medication.
This review suggests that the risk assessment for an implant patient should not be based on age, but rather on the patient's specific risk factors, such as former and current diseases and medication.
概述医学和老年因素对种植体存留率的影响,以便为从业者形成临床建议。
进行本叙述性文献综述以回答以下问题:(1)年龄(>75岁)是否为种植体存留的危险因素?;(2)糖尿病是否为种植体存留的危险因素?;以及(3)抗吸收治疗是否为种植体存留的危险因素?检索了PubMed、科学网(汤森路透)和谷歌学术数据库,查找截至2019年2月发表的关于每个主题的II级及以上证据水平的系统评价和研究论文。
(1)根据短期随访(1至5年),年龄>75岁不影响种植体存留。然而,该患者群体应考虑多种药物治疗情况。(2)糖尿病在短期内不是种植体存留的危险因素,但缺乏关于适当围手术期治疗和伤口闭合的信息。文献中几乎没有关于糖尿病患者骨移植和逐步加载方案成功与否的证据。(3)不建议对接受高剂量双膦酸盐和抗体治疗的患者进行种植治疗。抗吸收治疗期间应避免骨移植。对于接受抗吸收药物治疗的种植体周围炎患者,没有可用的治疗方案。
本综述表明,对种植患者的风险评估不应基于年龄,而应基于患者的特定危险因素,如既往和当前疾病及用药情况。