How old is old for implant therapy in terms of early implant losses?

Abstract

Objectives: To assess, retrospectively, whether older age has an impact on implant osseointegration when compared with younger age.

Methods: All patients ≥65 years old at implant installation, in an university setting over a time-period of 11.5 years, with complete anamnestic data and follow-up until prosthetic restoration were included, and any early implant loss (EIL; i.e. lack of osseointegration prior to or at the time-point of prosthetic restoration) was recorded. Further, one implant, from each of the elderly patients, was attempted matched to one implant in a younger patient (35 to <55 years old at implant installation) from the same clinic based on (a) gender, (b) implant region, (c) smoking status and (d) bone grafting prior to/simultaneously with implant installation. The potential impact of various local and systemic factors on EIL in the entire elderly population, and in the matched elderly and younger patient group was statistically assessed.

Results: Four hundred forty-four patients ≥65 years old (range 65.1-91.3; 56.8% female) receiving 1,517 implants were identified; 10 patients had one EIL each (implant/patient level: 0.66/2.25%). Splitting this patient cohort additionally into four age groups [65-69.9 (n = 213), 70-74.9 (n = 111), 75-79.9 (n = 80) and ≥80 (n = 40)], EIL was on the implant level 0.41, 0.83, 0.34 and 2.26%, respectively, (p = .102) and on the patient level 1.41, 2.70, 1.25 and 7.50%, respectively, (p = .104); multilevel analysis showed weak evidence of association of increasing age with higher EIL rate (p = .090). Matching was possible in 347 cases, and 5 (1.44%) and 9 (2.59%) EIL in the elderly and younger patients, respectively, were observed (p = .280). EIL could not be associated with any systemic condition or medication intake.

Conclusions: Elderly patients ≥65 years old presented a similarly low EIL rate as younger patients 35 to <55 years old, while patients ≥80 years old may have a slight tendency for a higher EIL rate. Hence, ageing does not seem to compromise osseointegration, and if at all, then only slightly and at a later stage of life.

Keywords: dental implant; early implant loss; elderly population; osseointegration.

Conflict of interest statement

The authors declare no conflict of interest related to this study.

© 2019 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.

Figures

Figure 1

EIL rate (%) on the patient (light blue) and implant (dark blue) level in the elderly patient cohort (n = 444), divided into 4 sub‐cohorts. The matched population (young patient cohort is displayed in light purple, elderly patient cohort in dark purple) consisted of 347 patients contributing with one implant each. The numbers on top of the bars present the actual numbers of EIL out of the total numbers of patients/implants, and the white numbers inside the bars represent the relative risk for EIL compared to the sub‐cohort of patients ≥80 years of age or compared to the matched elderly patient cohort, respectively