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.

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

Purpose: The objective of this study was to investigate if intellectual disability (ID) itself constitutes an absolute contraindication to oral rehabilitation with osseointegrated implants, or if adequately selected patients can benefit from this dental treatment technique. Method: We report a series of eight patients with non-syndromic ID and no associated neuromuscular disorders, craniofacial abnormalities, or serious systemic complications, in whom oral rehabilitation was performed using implant-supported prostheses, with a follow-up of one to three years. Results: A total of 18 titanium implants were inserted and nine implant-supported prostheses were constructed. Follow-up examination showed that although the majority of implants presented a degree of peri-implant mucositis, all were osseointegrated and the prostheses were functional. Conclusions: Although there is very little literature on this subject, the results of this pilot study allow us to suggest that osseointegrated oral implants could cons...

Osseointegrated dental implants in patients with intellectual disability: a pilot study.

Structured summary 2 Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number. 66-68

Total tooth loss and oral health service use among older people with intellectual disabilities in Ireland

Patients with Down syndrome often present with hypodontia, periodontal disease and early tooth loss. The treatment of a 49-year-old man by a surgical, implant/ prosthodontic approach is described. Research shows that dentures are not always the best solution for edentulous patients. Patients with disabilities are often excluded from advanced dental treatment options. This case aims to demonstrate that although implants are not suitable for all patients, they can be successful, for carefully chosen candidates irrespective of any disability.

/pdf/implant-surgical-and-prosthodontic-treatment-for-a-patient-8qew28x2lo.pdf

Implant, surgical and prosthodontic treatment for a patient with Down syndrome - a case report

Statement of problem Implant-supported prostheses for individuals with special needs have been considered high-risk because of the prevalence of poor oral hygiene and parafunction in this population; however, systematic evidence on protocols and outcomes is scarce. Purpose The purpose of this systematic review was to summarize implant procedures and outcomes for the special needs population. Material and methods A systematic literature review was conducted using PubMed, Embase, and Scopus databases in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodological framework. Data collected included patient information, location and number of implants, surgical and prosthetic procedures, behavior support techniques, postoperative follow-up, complications, and criteria for outcome assessment. Survival rates were pooled for quantitative analysis, and a separate analysis pooling data from groups of special needs patients that present similar risks was undertaken. Results The qualitative analysis included 79 studies involving 759 patients and 2269 implants. The quantitative analysis included 65 studies concerning 666 patients with special needs and 1886 implants. The overall weighted implant survival rate was 95.4%, with a mean follow-up duration of 40.7 ±29.5 months. Conclusions In individuals with special needs considered suitable for implant-supported prostheses by their clinician, implant survival rates were similar to those reported in the general population. (J Prosthet Dent xxxx;xxx:xxx-xxx) 

Implant-supported prostheses in patients with special needs: A systematic literature review of protocols and outcomes.

Individuals with cognitive disabilities face many barriers to oral care, often suffering from partial or complete edentulism. While the use of implant reconstruction is becoming more common in the general population, such care is still being used infrequently in individuals with intellectual impairment. A pilot project in 1995 surgically placed and restored implant-supported prostheses in six edentulous adults who had varying degrees of cognitive impairment. This report presents the dentists' reconstruction experiences and the patients' follow-up care, and discusses the results in relationship to current literature. Experiences from these patients suggest that behavior during the restorative process, prosthetic complications post placement, and patients' oral hygiene practices should influence patient selection and prosthetic design. Anteriorly placed fixtures and removable designs, which make self-care and repair easier, can be used to treat an edentulous population.

Dental Implants in Edentulous Adults with Cognitive Disabilities: Report of a Pilot Project

Re: "Functional Versus Anatomical Forms of Nasolacrimal Duct Obstruction: Differences in Severity, Symptoms, and Quality of Life".

Abstract Background  Previous studies have sought to outline the clinical practice of hand surgeons with plastic surgery training backgrounds. Still, minimal data exist characterizing the scope of hand surgery among plastic surgeons, regardless of the subspecialty fellowship training. Methods  All hand procedures logged in the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) database from 2002 to 2016 were identified by the Common Procedural Technology (CPT) code and/or “upper extremity” anatomic classification. Trends in the total number and types of procedures, facility type, admission type, modes and providers of anesthesia, and patient demographics were reviewed. Results  A total of 182,137 hand procedures performed on 82,811 patients during the 15-year period were reviewed. Sixty-eight percent of procedures involved soft tissue only, and 22.7% involved only bone and/or joint. The most common procedure categories included the following: wound closure/coverage (15.8%), debridement/drainage (15.3%), nerve (13.2%), tendon (12.9%), and fracture/dislocation (12.9%). Ambulatory and office-based procedures increased over time, along with the use of local anesthetic, as well as a transition from the procedural surgeon providing anesthesia to the use of anesthesiologists and nurse anesthetists. In addition, hand procedures have remained a considerable proportion of all logged procedures but have seen a steady decline since 2014. Conclusion  Plastic surgeons play an important role in the field of hand surgery, performing a wide variety of procedure types, which has remained stable over time. The trends in facility type and anesthesia characteristics have, however, varied.

Practice Trends in Plastic Hand Surgery: An Evaluation of Cases in the TOPS Database

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Papers

Dental Implants in Edentulous Adults with Cognitive Disabilities: Report of a Pilot Project

Re: "Functional Versus Anatomical Forms of Nasolacrimal Duct Obstruction: Differences in Severity, Symptoms, and Quality of Life".

Practice Trends in Plastic Hand Surgery: An Evaluation of Cases in the TOPS Database