دانلود رایگان مقاله انگلیسی ایمپلنت دندان در بیماران مبتلا به دیسپلازی اکتودرم: بررسی سیستماتیک - الزویر 2018

ABSTRACT

Purpose. This study sought to assess the clinical outcome and survival rate of oral implants placed in individuals with ectodermal dysplasia (ED), based on previously published studies. Methods. An electronic search without time restrictions was undertaken in 5 databases (PubMed/Medline, Web of Science, ScienceDirect, J-Stage, Lilacs). Descriptive statistics, Kaplan Meier estimator and implant failure probability were calculated. Results. 90 publications were included, reporting 228 ED patients that received 1472 implants (1392 conventional, 47 zygomatic, 33 mini-implants). Mean age of the patients was 20.2±6.8 years (2-56). Patients had a mean of 3.2±2.5 maxillary and 2.1±2.6 mandibular permanent teeth (min-max, 0-14). Patients received a mean of 8.2±3.8 implants (1-20). Most implants were placed in the third decade of life, 24.6% of the implants were placed in children (0-17 years of age). 1391 implants had information on follow-up (72 failures, 5.2%). The 20-year CSR was 84.6%. The probability of failure was 4.5% (95%CI 3.5%-5.6%, p<0.001). Additional treatments performed were Le Fort I (99 implants, 20 patients, 3.5% failed), grafting (497 implants, 77 patients, 5.2% failed), distraction osteogenesis (79 implants, 16 patients, 10.1% failed). Mean follow-up was 42.9±41.9 months (min-max, 2-240). Conclusions. Dental implants placed in ED patients, either infants or adults, present a high survival rate (20-year CSR 84.6%).

DISCUSSION

The oral rehabilitation of patients with implants is generally delayed until the cessation of growth because an implant does not exhibit dentoalveolar adaptation in response to vertical alveolar growth or local bony remodeling as would occur in the case of a tooth (Björk and Skieller, 1972; Thilander et al., 1992). However, the use of removable dentures in the deficient residual basal bone structures usually observed in individuals with ED could be a cause of functional and psychological problems. Moreover, the salivary gland hypoplasia in ED patients typically leads to mucosal drying, which can cause poor removable denture retention and make it difficult for children to use removable dentures (Wang et al., 2016). Therefore, the use of dental implants before the cessation of growth in ED patients is encouraged by some dentists (Guckes et al., 1998).