title: Four years survival and marginal bone loss of implants in patients with Down syndrome and cerebral palsy.
abstract: OBJECTIVE
  To evaluate implant survival rate and marginal bone loss (MBL) after 4 years in patients with Down syndrome and cerebral palsy, compared with a healthy control group.
  
  
  METHODS
  The case group comprises 102 implants in 19 patients (71 cerebral palsy, 21 Down syndrome), and the control group comprises 70 implants in 22 healthy patients. One implant per patient was selected (n = 41 implants) to take clustering effects into account. MBL was measured using two panoramic radiographs (after surgery and 4 years later). Lagervall-Jansson's Index was used. Statistics used are chi-squared test and Haberman's post hoc test. p Value is significant at <0.05.
  
  
  RESULTS
  MBL was significantly higher in the cases in all samples (p < 0.001) and when one implant was selected per patient (p < 0.05). More implants were lost in the cases (p < 0.01), especially those with a higher MBL (p < 0.01). MBL (p < 0.05) and implant loss (p < 0.01) increased with age in the cases. The three-unit fixed dental prosthesis (FDP) showed higher MBL (p < 0.05). Down syndrome had a higher MBL than cerebral palsy (entire sample p < 0.0001, one implant per patient p < 0.05). All patients with Down syndrome saw some damage to bone support (entire sample p < 0.0001; one implant per patient p < 0.05). Implant loss occurred only in Down syndrome (p < 0.00001).
  
  
  CONCLUSIONS
  MBL and implant loss 4 years after placement are higher in neuropsychiatric disabilities. Down syndrome has a higher risk of MBL and implant loss; therefore, special precautions should be taken when deciding on treatment for these patients.
  
  
  CONCLUSIONS
  As a consequence of this pilot study, professionals should be very cautious in placing implants in patients with Down syndrome.
authors.affiliation: Department of Estomatology, University of Seville, Seville, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Corcuera-Flores
authors.affiliation: Hospital Nen Deu, Barcelona, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: López-Giménez
authors.affiliation: Hospital Nen Deu, Barcelona, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: López-Jiménez
authors.affiliation: Hospital Nen Deu, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: López-Giménez
authors.affiliation: Department of Estomatology, University of Valencia, Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Silvestre-Rangil
authors.affiliation: Department of Estomatology, University of Seville, Seville, Spain. gmachuca@us.es.|School of Dentistry, c/ Avicena s/n, 41009, Sevilla, Spain. gmachuca@us.es.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Machuca-Portillo
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications*; D003730:Dental Care for Persons with Disabilities; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects*; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015921:Dental Implants
keywords: Cerebral palsy; Dental implants; Down syndrome; Marginal bone loss