Maintenance issues of elderly patients requiring nursing care with implant treatments in dental visiting: position paper.

PURPOSE: Japan, with an increasing number of elderly people needing long-term care in a super-aged society, urgent needs to develop the clinical guidelines on implant maintenance for elderly people with declining independence. The purpose is to categorize the troubles encountered in the care of patients with dental implants and to indicate actual practices and points of note. METHODS: From the members of the Japanese Society of Oral Implantology, 12 expert panelists who were experienced with many problems of implant maintenance during dental visits and were familiar with their solutions were selected. Through repeated discussions in the many panel meetings, the problems of implant maintenance during dental visits were distilled. RESULTS: During a dental visit, the oral cavity, general conditions, and background of elderly patients who cannot orally care for themselves must be grasped, and medical staff, care managers, and patients should understand the changes in these factors as time goes by. The solutions and responses that can be made differ greatly depending on the medical care facilities, the environment, differences in the experience of medical staff, and the patient's background. Thus, it is necessary to select safe treatments appropriate to each situation. CONCLUSIONS: This paper features many opinions based on clinical experiences. However, clinical guidelines on implant management during dental visits should be formulated in the future based on the accumulation of evidence through the implementation of clinical research.

Implant Site Development by Horizontal Tooth Movement to an Esthetic Area: A Case Report.

This case report describes the treatment of a woman who lost a central incisor. The socket developed severe tissue defects. She rejected hard and soft tissue management and the use of biomaterials. The lateral incisor was moved mesially with orthodontic treatment. The tissue defects were filled with the alveolar bone of the moved tooth and adequate bone volume was generated behind it. An implant was placed in the space that was generated without any tissue augmentation. The moved tooth had sound periodontal tissue and was restored without preparation. The horizontal tooth movement enabled an esthetic outcome with minimal intervention.