Is It Really Just a Number? Age as a Risk Factor for Peri-implantitis

Abstract

This study aims to identify whether increased age is a risk factor for peri-implantitis. A retrospective cohort study design was conducted to evaluate implants placed between 2006 and 2013 at the Philadelphia VA Medical Center. Dental encounter notes were used to gather data about implant placement by either attendings or residents. Participants’ ages ranged from 31 to 89. Implant status was assessed using dental encounter notes from follow-up appointments in which peri-implantitis and associated implant failures were recorded. Of the 1362 implants placed in 398 patients, 899 implants in 285 unique patients met the inclusion criteria. Descriptive statistics was used to analyze the data with P < .05 used to define statistical significance. Descriptive statistics were computed using the SAS System (SAS Institute Version 9.4, 2002-2012, Cary, NC). The predictor variable was age 60 and above. The primary outcome variable was the presence of peri-implantitis, with P < .05 used to define statistical significance. Of the 889 implants available for analysis, 205 developed peri-implantitis. Of the 586 implants placed in patients age 60 and over, peri-implantitis occurred in 152 (25.9%). Patients under the age of 60 received 303 implants, with 54 (17.8%) developing peri-implantitis. When compared to implants placed in younger patients via computation of an odds ratio, implants placed in patients who are 60 or more years old have a 60% increased risk (OR: 1.600; 95% CL 1.130-2.265) of developing peri-implantitis (P = .0080). Further analyses found that in patients over 60 years old, 72.4% of peri-implantitis cases were for implants placed in the maxilla. The results from this study demonstrate that increasing age is a risk factor for peri-implantitis. A retrospective cohort study previously found that age ≥ 65 years (P = .001) is strongly associated with the development of peri-implantitis, which is consistent with our study (although our results suggests that age may become a risk factor by 60 years old).1 This increased incidence of peri-implantitis observed in older patients has many possible explanations, including prevalence of chronic systemic disease (e.g., diabetes mellitus, cardiovascular disease) and diminished ability to perform oral hygiene maintenance in elderly patient populations.2 Our findings indicate that older patients can expect a poorer prognosis following dental implant surgery. As the average age of the population increases and more elderly people are eligible to receive dental implants, our findings suggest that future research should establish what measures can be taken to improve outcomes specifically for aging patients.