Implant Survival in Patient Populations With a Mean Age of 65-75 Years Compared to Older Cohorts: A Systematic Review and Meta-Analysis.

OBJECTIVES

To evaluate implant survival and success rates in elderly patients, comparing younger old adults (65-75 years) to older implant patients (> 75 years).

METHODS

A systematic search was conducted using Medline, Cochrane Library, and PubMed Central for clinical studies on implant therapy in patients aged 65 and older. Outcomes included implant survival and success rates, peri-implant parameters, bone-level changes (BLC), and type of restoration and retention. Three- and five-year survival and success rates, as well as implant loss per 100 implant-years, were estimated with 95% confidence intervals (CI). Poisson regression models and incidence rate ratios (IRR) were used to compare study groups, and meta-regression with restricted maximum likelihood estimation (REML) assessed BLC.

RESULTS

Twenty-seven studies with a total of 3892 implants were included. Patients > 75 years had significantly higher five-year survival rates (96.8%, CI: 95.9-97.5) compared to the 65-75 age group (92.1%, CI: 83.0-96.4; p = 0.031), with lower implant loss rates per 100 implant-years. No significant difference in success rates was observed (p = 0.229). Although plaque and bleeding on probing (BOP) were more frequent in the older group, there was no significant difference in BLC (mean difference: 0.41 mm; p = 0.189). In patients > 65 with implant overdentures, single attachments showed significantly higher implant loss rates than bars (p = 0.035).

CONCLUSIONS

Dental implants are a reliable treatment for older adults, including those over 75 years. Despite more frequent plaque and BOP in the older group, peri-implant bone remained stable. Splinting implants in overdenture wearers aged > 65 is associated with 5.6 times higher survival rates.