Patient-related outcome measures and clinical evaluation of dental implant therapy in the elderly population – a cross-sectional study

Svetlana Dragović; Zoran Lazić; Miroslav Dragović; Miroslav Vukadinović; Biljana Miličić; Aleksandra Špadijer Gostović

doi:10.2298/VSP190228124D

Svetlana Dragović University of Belgrade, Faculty of Dental Medicine, Clinic for Prosthodontics, Belgrade, Serbia
Zoran Lazić Military Medical Academy, Clinic for Maxillofacial, Oral Surgery and Implantology, Belgrade, Serbia
Miroslav Dragović University of Belgrade, Faculty of Dental Medicine, Clinic for Oral Surgery, Belgrade, Serbia
Miroslav Vukadinović University of Belgrade, Faculty of Dental Medicine, Clinic for Maxillofacial Surgery, Belgrade, Serbia
Biljana Miličić University of Belgrade, Faculty of Dental Medicine, Department of Medical Statistics and Informatics, Belgrade, Serbia
Aleksandra Špadijer Gostović University of Belgrade, Faculty of Dental Medicine, Clinic for Prosthodontics, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP190228124D

Keywords: dental implants, aged, surveys and questionnaires, quality of life, patient satisfaction

Abstract

Background/Aim. Oral health disorders are crucial regarding general health and quality of life of the elders. The aim of this cross-sectional study was to evaluate the long-term clinical and patient-centered outcomes of dental implants, placed in partially and fully edentulous people older than 65 years. Methods. A total of 38 participants with an overall number of 168 implants were selected and underwent clinical and radiological examination. The implant survival rate, implant failure rate and other complications were recorded and analyzed. All participants agreed to respond to the Oral Health Impact Profile-14 (OHIP-14) questionnaire and another questionnaires on the Visual Analog Scale (VAS) related to their experiences and satisfaction with the overall implant treatment. Univariate and multivariate regression models were used to verify the relation between the OHIP score and the VAS questionnaires’ items. Results. The implant survival rate was 94.3%. The number of implants without any complication was 73.2% (123), while biological and technical ones occurred in 17.3% (29) and 9.5% (16) implants, respectively. Regarding quality of life, significant difference was found only between those who wear fixed and removable restauration (p = 0.001). The multivariate regression model showed that the degree of satisfaction with shape and size of dentures was significantly associated with lower OHIP scores, indicating a better quality of life. Conclusion. According to the results obtained, it can be concluded that dental implant therapy in elderly people can be considered as predictable long-term treatment option regarding high implant survival rate, minimal complications and significantly better quality of life found in the group with fixed dentures.

References

World Health Organization (WHO). Active Ageing: A Policy Framework. A Contribution of the World Health Organiza-tion to the Second United Nations World Assembly on Age-ing. Madrid, Spain: World Health Organization (WHO; 2002.

Kowal P, Goodkind D, He W, An Aging World: 2015. Interna-tional Population Reports. Washington DC: U.S. Govern-ment Printing Office; 2016. Available from: http://www.census.gov/library/publications/2016/demo/P95-16-1.html

Murray Thomson W. Epidemiology of oral health conditions in older people. Gerodontology 2014; 31 Suppl 1: 9‒16.

Muller F, Naharro M, Carlsson GE. What are the prevalence and incidence of tooth loss in the adult and elderly population in Europe? Clin Oral Implants Res 2007; 18 Suppl 3: 2‒14.

Heydecke G, Thomason JM, Lund JP, Feine JS. The impact of conventional and implant supported prostheses on social and sexual activities in edentulous adults: Results from a random-ized trial 2 months after treatment. J Dent 2005; 33(8): 649‒57.

Geissler CA, Bates JF. The nutritional effects of tooth loss. Am J Clin Nutr 1984; 39(3): 478‒89.

Jemt T. Implant treatment in elderly patients. Int J Prostho-dont 1993; 6(5): 456‒61.

Kondell PA, Nordenram A, Landt H. Titanium implants in the treatment of edentulousness: influence of patient’s age on prognosis. Gerodontics 1988; 4(6): 280‒4.

Zarb GA, Schmitt A. Osseointegration for elderly patients: The Toronto study. J Prosthet Dent 1994; 72(5): 559‒68.

Park JC, Baek WS, Choi SH, Cho KS, Jung UW. Long-term outcomes of dental implants placed in elderly patients: a retro-spective clinical and radiographic analysis. Clin Oral Implants Res 2017; 28(2): 186‒91.

De Bruyn H, Raes S, Matthys C, Cosyn J. The current use of pa-tient-centered/reported outcomes in implant dentistry: a sys-tematic review. Clin Oral Implants Res 2015; 26 Suppl 1: 45‒56.

Reissmann DR, Dard M, Lamprecht R, Struppek J, Heydecke G. Oral health-related quality of life in subjects with implant-supported prostheses: A systematic review. J Dent 2017; 65: 22‒40.

World Medical Association. World Medical Association Declara-tion of Helsinki: ethical principles for medical research involv-ing human subjects. JAMA 2013; 310(20): 2191‒4.

Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986; 1(1): 11‒25.

Mombelli A, van Oosten MA, Schurch E Jr, Land NP. The micro-biota associated with successful or failing osseointegrated tita-nium implants. Oral Microbiol Immunol 1987; 2(4): 145‒51.

Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol 1997; 25(4): 284‒90.

Stancic I, Sojic LT, Jelenkovic A. Adaptation of Oral Health Im-pact Profile (OHIP-14) index for measuring impact of oral health on quality of life in elderly to Serbian language. Vojno-sanit Pregl 2009; 66(7): 511‒5. (Serbian)

Rashid F, Awad MA, Thomason JM, Piovano A, Spielberg GP, Scil-ingo E, et al. The effectiveness of 2-implant overdentures - a pragmatic international multicentre study. J Oral Rehabil 2011; 38(3): 176‒84.

Becker W, Hujoel P, Becker BE, Wohrle P. Dental Implants in an Aged Population: Evaluation of Periodontal Health, Bone Loss, Implant Survival, and Quality of Life. Clin Implant Dent Relat Res 2016; 18(3): 473‒9.

Serino G, Ström C. Peri-implantitis in partially edentulous pa-tients: Association with inadequate plaque control. Clin Oral Implants Res 2009; 20(2): 169‒74.

Allen P, McMillan A. A longitudinal study of quality of life outcomes in older adults requesting implants prostheses and complete removable dentures. Clin Oral Implant Res 2003; 14(2): 173‒9.

De Bruyn H, Raes S, Matthys C, Cosyn J. The current use of pa-tient-centered/reported outcomes in implant dentistry: A sys-tematic review. Clin Oral Implants Res 2015; 26(Suppl 11): 45‒56.

Awad MA, Feine JS. Measuring patient satisfaction with man-dibular prostheses. Community Dent Oral Epidemiol. 1998; 26(6): 400‒5.