Dental implants in the elderly population: a systematic review and meta-analysis.
OBJECTIVE
This systematic review was conducted to evaluate the outcome of dental implant therapy in elderly patients (≥65 years).


METHODS
Online database and hand searches were systematically performed to identify studies reporting on dental implants placed in the partially/completely edentulous jaws of elderly patients. Only prospective studies reporting on regular-diameter (≥3 mm), micro-rough surface implants were included in this review. Two investigators performed the search and data extraction. An inter-investigator reliability was verified using kappa statistics (κ). A meta-analysis was performed on implant survival rates, while the mean peri-implant marginal bone level changes (PI-MBL), technical/mechanical complications, and biological complications were reported descriptively.


RESULTS
The systematic search yielded 2221 publications, of which 11 studies were included for statistical analyses. The calculated κ for the various parameters extracted was κ = 0.818-1.000. A meta-analysis was performed on the post-loading implant survival rates at 1, 3, 5, and 10 years. The random-effects model revealed an overall 1-year implant survival of 97.7% (95% CI: 95.8, 98.8; I2= 0.00%, P = 0.968; n = 11 studies). The model further revealed an overall implant survival of 96.3% (95% CI: 92.8, 98.1; I2= 0.00%, P = 0.618; n = 6 studies), 96.2% (95% CI: 93.0, 97.9; I2= 0.00%, P = 0.850; n = 7 studies), and 91.2% (95% CI: 83.4, 95.6; I2= 0.00%, P = 0.381; n = 3 studies) for 3, 5, and 10 years, respectively. The reported 1-year average PI-MBL ranged between 0.1 and 0.3 mm, while the reported 5- and 10-year PI-MBL were 0.7 and 1.5 mm, respectively. Information obtained pertaining to the technical and biological complications in the included studies was inadequate for statistical analysis. The frequent technical/mechanical complications reported were abutment screw loosening, fracture of the overdenture prostheses, activation of retentive clips, ceramic chipping, and fractures. The common biological complication reported included peri-implant mucositis, mucosal enlargement, bone loss, pain, and implant loss.


CONCLUSIONS
This review provides robust evidence favoring dental implant therapy in elderly patients as a predictable long-term treatment option, in terms of implant survival, clinically acceptable PI-MBL changes, and minimal complications. Therefore, age alone should not be a limiting factor for dental implant therapy.
Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Murali
http://orcid.org/0000-0003-3365-576X
M
Srinivasan
Division of Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Simon
S
Meyer
Division of Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Andrea
A
Mombelli
Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.|Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland.
Frauke
F
Müller
D000367:Age Factors; D000368:Aged; D003757:Dental Implantation; D015921:Dental Implants; D019232:Dental Restoration Failure; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery; D016896:Treatment Outcome
D015921:Dental Implants
aged 65 years and over; dental implants; edentulous jaws; elderly patients; implant survival; meta-analysis; survival rate; systematic review