Clinical Report of the Immediate Placement Implants in Patients Aged 80 and Over: Five Cases and a Short Review
With the population aging, the proportion of elderly individuals is expected to increase, and the proportion of individuals over 80 is also likely to increase. Given that the population is aging and life expectancy is increasing, elderly patients who have lost their teeth will also increase. Impaired masticatory function caused by tooth loss is a risk factor for cognitive decline and frailty, and neglecting to treat tooth loss is a critical issue. In this report, 5 patients over 80 requested dental implants for new missing teeth and underwent immediate implant placement. All patients were treated by the same surgeon using the same technique, materials, and dental implants. Five elements were measured for the peri-implant bone from the cone-beam computed tomography images. All patients were followed for 3 or more years and exhibited good progress without any abnormal findings in their oral cavities or notable radiographic abnormalities such as bone absorption or peri-implantitis. Compared with conventional treatment with delayed placement, combining immediate implant placement and regenerative medicine for fixed superstructures may be the better option for missing tooth replacement if the conditions are suitable. Thus, this treatment modality may improve the quality of life in elderly patients, especially super elderly patients.
Cone-beam computed tomography (CBCT) measurement points and the identification of each peri-implant bone. The measurement positions of the identification of each peri-implant bone coronal sections (voxel size = 0.16 mm) obtained using a CBCT apparatus instrument (NINJA Viewer). Measurement elements of the identification of each peri-implant bone are shown. (1) VHB, vertical height from the buccal of alveolar crest (BAC) to the buccal of base of defect (BVD), (2) HWB, horizontal width from the implant shoulder to the buccal of alveolar wall, (3) VHL, vertical height from the lingual of alveolar crest (LAC) to the lingual of base of defect (LVD), (4) HWL, horizontal width from the implant shoulder to the lingual of alveolar wall, (5) ABD, area of bone defect. BAC, buccal of alveolar crest; LAC, lingual of alveolar crest; BBD, buccal of base of defect; LBD, lingual of base of defect; IS, implant shoulder.
Clinical photograph and radiograph showing case 1 (M81-13). (a) Intraoral examination at the initial visit. Buccal side of tooth #13. (b) Panoramic radiography at the initial visit. (c) Cone-beam computed tomography images of tooth #13. (d) Fresh sockets after extraction. (e) Extracted tooth #13. (f) Centrifuged platelet-rich fibrin. (g) Dental implant was covered with the PRGF F2. (h) Dental implant was placed into fresh sockets. The autogenous PRGF combined with bovine-derived xenograft was placed into the space between the implant and the socket walls. (i) The autogenous PRGF combined with bovine-derived xenograft. (j) PRGF F1 membrane. (k) The wound was covered with a PRGF F1 membrane. (l) Cone-beam computed tomography images after implant placement. (m) Occlusal view of Zirconia bonded crown with screw fixation of tooth #13. (n) Intraoral photograph 2 years after surgery. (o) Cone-beam computed tomography images 2 years after surgery. (p) Periapical radiography images 5 years after surgery.
Cone-beam computed tomography images and clinical photograph showing case 2 to 5. (a–d) Showing case 2, (e–h) showing case 3, (i–l) showing case 4, (m–p) showing case 5. (a, e, i, m) Cone-beam computed tomography images at the initial visit. (b, f, j, n) Clinical photograph showing dental implant placed in fresh socket. (c, g, k, o) The autogenous PRGF combined with bovine-derived xenograft was placed into the space between the implant and the socket walls. (d, h, l, p) Cone-beam computed tomography images 3 years after surgery.
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