Treatment with implant-supported fixed dental prostheses in patients with congenital and acquired neurologic disabilities: a prospective study.

PURPOSE: To study the medium- to long-term outcome of implant treatment in patients with neurologic disabilities.

MATERIALS AND METHODS: Twenty-seven patients with different disabilities and in need of prosthodontic treatment were treated with various implant-supported prostheses. Altogether, 88 threaded titanium implants were placed. General anesthesia was used in 21 patients and local anesthesia in 6 patients. Patients were recalled every 3 months by a dental hygienist and annually by a prosthodontist.

RESULTS: Five of the original 27 patients died during the 5- to 10-year follow-up period (mean, 7.2 years), but the remaining 22 patients with 70 implants could be clinically examined at the final follow-up. Twelve implants (14%) were lost, 3 before loading and 9 after insertion of the implant-supported fixed prostheses. The cumulative survival rate for placed implants was 85.8% after 10 years. Perimucositis was diagnosed in 10 patients and for 14 of the 70 implants. Three of the 15 patients with measurable radiographs and 4 implants were diagnosed with peri-implantitis. Several prosthodontic complications occurred, from minor and easily correctable to severe and requiring retreatment.

CONCLUSIONS: Patients with different neurologic disabilities present more problems during implant treatment and maintenance compared with healthy patients. Nevertheless, it was possible to carry out treatment, and outcomes were relatively favorable. The results indicate that implant treatment can be a valid option in oral rehabilitation of patients with neurologic disabilities.