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
PubMed ID Author / Year Patient Group Study type (level of evidence) 22211305 Lang/2012 Patients receiving dental implants Systematic Review Key results A 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%). 10531746 Isidor/1999 8 women with Sjogren’s Syndrome with oral symptoms receiving 54 implants Case Report Key results The 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	(General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords	Sjogren’s Syndrome, Dental Implants
ID#	2406
Date of submission	04/03/2013
E-mail	Sigurdson@livemail.uthscsa.edu
Author	Shaun Sigurdson
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Michaell Huber, DDS
Faculty mentor e-mail	HuberM@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Vrinda Gupta (San Antonio, TX) on 10/16/2021 I conducted a PUBMED search on this topic in October 2021 and found more recent publications (systemic reviews). The recent systemic reviews provide better insight into the topic. PMID: 29240793, PMID: 30827571 Both reviews suggest that the dental implant therapy in patients with Sjogren's Syndrome seems to present high implant survival rate but provide contradictory evidence about marginal bone loss around implants.