Evaluation of surgical techniques in survival rate and complications of zygomatic implants for the rehabilitation of the atrophic edentulous maxilla: a systematic review.

PURPOSE: To assess the outcome [zygomatic implant (ZI) survival] and complications of the original surgical technique (OST) and an Anatomy-Guided approach (AGA) in the placement of ZI in patients with severely atrophic maxillae. METHODS: Two independent reviewers conducted an electronic literature search from January 2000 to August 2022. The inclusion criteria were articles reporting at least five patients with severely atrophic edentulous maxilla undergoing placement OST and/or AGA, with a minimum of 6 months of follow-up. Number of patients, defect characteristics, number of ZI, implant details, surgical technique, survival rate, loading protocol, prosthetic rehabilitation, complications, and follow-up period were compared. RESULTS: Twenty-four studies comprised 2194 ZI in 918 patients with 41 failures. The ZI survival rate was 90.3-100% in OST and 90.4-100% in AGA. Probability of complications with ZI with OST was as follows: sinusitis, 9.53%; soft tissue infection, 7.50%; paresthesia, 10.78%; oroantral fistulas, 4.58%; and direct surgical complication, 6.91%. With AGA, the presenting complications were as follows: sinusitis, 4.39%; soft tissue infection, 4.35%; paresthesia, 0.55%; oroantral fistulas, 1.71%; and direct surgical complication, 1.60%. The prevalence of immediate loading protocol was 22.3% in OST and 89.6% in the AGA. Due to the heterogeneity of studies, statistical comparison was only possible after the descriptive analysis. CONCLUSIONS: Based on the current systematic review, placing ZI in severely atrophic edentulous maxillae rehabilitation with the OST and AGA is associated with a high implant survival rate and surgical complications within a minimum of 6 months follow-up. Complications, including sinusitis and soft tissue infection around the implant, are the most common. The utilization of immediate loading protocol is more observed in AGA than in OST.

Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

PURPOSE: Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. MATERIALS AND METHODS: Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. RESULTS: A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P < .05). Furthermore, implant patients in younger age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P < .05). CONCLUSION: A consistent pattern of mortality in different age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

Number of teeth--a predictor of mortality in 70-year-old subjects.

OBJECTIVES: To investigate whether the number of teeth at age 70 is an independent predictor of mortality. METHODS: Within the gerontological population studies in Göteborg, Sweden, four birth cohorts born in 1901/1902, 1906/1907, 1911/1912 and 1922 were examined cross-sectionally at 70 years of age. The total number of participants in the odontological cohorts was 1803. Mortality data were collected from the national Swedish health registers. Cox regression models were used to measure the association between mortality and the number of teeth with adjustment for covariates such as health factors, socio-economic and lifestyle factors. RESULTS: The prevalence of edentulism showed a marked change from 51% in the first cohort to 16% in the last cohort. The 7-year mortality rate was 14% in women and 28% in men, and the highest in edentulous men in the last two cohorts (42% and 47% respectively). The 7-year mortality including all four cohorts showed a hazard ratio of 0.96 (95% CI 0.94-0.98; P < 0.001) for the number of teeth with adjustment for cohort. The corresponding 18-year mortality including the three first cohorts showed a hazard ratio of 0.98 for women and 0.97 for men. The number of teeth was an independent statistically significant predictor of 7-year mortality in both genders and of 18-year mortality in men. CONCLUSIONS: The result showed that each remaining tooth at age 70 decreased the 7-year mortality risk by 4%. The difference between edentulous subjects and dentate subjects with >or=20 teeth regarding 7-year mortality was significantly higher in the last compared to the first cohort. The number of teeth was a significant predictor of mortality independent of health factors, socio-economic status and lifestyle.