Dental implants in the elderly population: a systematic review and meta-analysis.

Abstract

This systematic review was conducted to evaluate the outcome of dental implant therapy in elderly patients (≥65years). 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 (≥3mm), 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. 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 10years. 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 10years, respectively. The reported 1-year average PI-MBL ranged between 0.1 and 0.3mm, while the reported 5- and 10-year PI-MBL were 0.7 and 1.5mm, 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. 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.