ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Patients With Sjogren’s Syndrome May Have A Reduced Dental Implant Survival Rate
Clinical Question In adult patients with Sjogren’s Syndrome, does dental implant treatment result in significantly higher implant failure than in healthy adult patients?
Clinical Bottom Line There is not enough evidence to conclude that Sjogren’s Syndrome has an impact on the survival of dental implants.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22211305Lang/2012Patients receiving dental implantsSystematic Review
Key resultsA total of 46 prospective studies, with a mean follow-up time of 2.08 years, were included. The annual failure rate of immediate implants was 0.82% (95% CI: 0.48-1.39%), translating into the 2-year survival rate of 98.4% (97.3-99%).
#2) 10531746Isidor/19998 women with Sjogren’s Syndrome with oral symptoms receiving 54 implantsCase Report
Key resultsThe 2 year survival rate of the 54 implants was 83.3%. 7 of the 54 implants were not osseointegrated as of two years after they were placed.
Evidence Search "Sjogren's Syndrome"[Mesh]) AND "Dental Implants"[Mesh] "Dental Implants"[Mesh] AND "Tooth Extraction"[Mesh] AND systematic[sb]
Comments on
The Evidence
Validity: The Lang article was a systematic review of 46 prospective studies using Medline and Cochrane Library. The survival rates were calculated using STATA statistical software. The Isidor article was a case-report of eight patients, a number too small to be conclusive. The Lang article defined an implant that had “survived” as: “implants remaining in situ at the follow-up examinations, irrespective of their conditions.” The Isidor article does not explicitly say what it defines implant survival as, but I interpreted failure to osseointegrate as not surviving. A problem with comparing implant success rates across multiple studies is that there is not a standard for defining implant success. Implant literature typically gives success rates of specific parameters, instead of a primary endpoint as a measure of success. “Success in implant dentistry should ideally evaluate a long-term primary outcome of an implant-prosthetic complex as a whole.” (Papaspyridakos, 2012) Once there is an accepted standard of measuring implant success then comparative studies may be more conclusive. Perspective: There have not been enough studies of the survival rate of implants in patients with Sjogren’s Syndrome to come to a definitive conclusion of whether or not the disease has an impact on implant survival.
Applicability When a clinician evaluates options for their patients with Sjogrens Syndrome they may take in to account that the implant survival rate is lower and may go with an alternative prosthodontic option.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Sjogren’s Syndrome, Dental Implants
ID# 2406
Date of submission: 04/03/2013spacer
E-mail Sigurdson@livemail.uthscsa.edu
Author Shaun Sigurdson
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Michaell Huber, DDS
Faculty mentor/Co-author e-mail HuberM@uthscsa.edu
Basic Science Rationale
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