Implant Overdentures In The Geriatric Population

1377 words - 6 pages

The Surgeon General’s report on oral health in America estimates that approximately 9.7% of the United States population over 18 years of age is edentulous.1,2 However, this figure increases to a staggering 33.1% when only individuals aged 65 year or older are considered. Furthermore, if geriatric individuals with single-arch edentulism are considered, the number rises to 50.4%.2 These statistics clearly demonstrate that is it this older population that is most afflicted by edentulism and consequences that may result from living with the condition.2 Improvements in dental care with a concurrent increase in the frequency of its use by the general population has lead to an overall decrease in ...view middle of the document...

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Prior to these developments alveolar ridge augmentations were commonly performed on edentulous patients with highly resorbed alveolar ridges unable to retain conventional complete dentures.6 Today, these patients have the option to attain support and retention for a conventional denture through the placement of dental implants. Traditionally, two implants are placed in the mandible, while two or four implants can be placed in the maxilla.6 Once osseointegration is complete, implant abutments are attached. Abutments designed for use with overdentures are unique because they are engineered to provide retention for the prosthesis and prevent unintentional dislodgement, but also allow the prosthesis to be willfully removed.
Implant overdentures have several advantages over conventional dentures. However, there is one benefit that is particularly noteworthy with regard to the geriatric patient: the ability to generate greater biting forces. Proper nutrition improves physical, psychological and emotional well being, but dental problems are among the top barriers to maintaining good nutrition.8 The older population has the highest prevalence of edentulism and is consequentially the most venerable to malnutrition.2,5 Masticatory function decreases alongside tooth loss, and even patients with well-fitting conventional dentures report difficulty chewing tough, fibrous foods like fruits, vegetables, and meats.2 When the diet is modified to accommodate functional insufficiencies, it will often include softer, more processed foods that tent to be higher in fat and cholesterol and lacking in macronutrients and micronutrients. Various studies have proven that implant overdentures significantly improve masticatory efficiency and that patients who wear these prostheses are better able to maintain proper nutrition.2,4,7
While research has proven the advantages of implant-supported overdentures within the geriatric population, older individuals are unfortunately more likely to face barriers to implant placement. Second to smoking, the presence of systemic disease is one of the most significant risk factors for implant failure. Systemic conditions frequently observed in the older population that may contraindicate the placement of dental implants include cancer, diabetes mellitus, cardiovascular disease, mental health conditions, osteoporosis, and arthritis.9, 10 Implants are contraindicated in patients with past or present cancer of the head and neck treated with radiation therapy. Radiation affects the vasculature of the bone and its ability to heal, predisposing the patient to osteoradionecrosis of the jaw (ONJ).9 Implants should be placed with caution. The elderly population has the highest prevalence of diabetes and these individuals are more likely to experience the various complications of longstanding hyperglycemia including impaired wound healing and immunosuppression.11 While implants may be successfully placed in well-controlled diabetic,...

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