مقاله انگلیسی رایگان در مورد ایمپلنت دندان در بیماران مبتلا به دیسپلازی اکتودرم – الزویر 2018

Purpose. This study sought to assess the clinical outcome and survival rate of oral implants placed in individuals with ectodermal dysplasia (ED), based on previously published studies. Methods. An electronic search without time restrictions was undertaken in 5 databases (PubMed/Medline, Web of Science, ScienceDirect, J-Stage, Lilacs). Descriptive statistics, Kaplan Meier estimator and implant failure probability were calculated. Results. 90 publications were included, reporting 228 ED patients that received 1472 implants (1392 conventional, 47 zygomatic, 33 mini-implants). Mean age of the patients was 20.2±6.8 years (2-56). Patients had a mean of 3.2±2.5 maxillary and 2.1±2.6 mandibular permanent teeth (min-max, 0-14). Patients received a mean of 8.2±3.8 implants (1-20). Most implants were placed in the third decade of life, 24.6% of the implants were placed in children (0-17 years of age). 1391 implants had information on follow-up (72 failures, 5.2%). The 20-year CSR was 84.6%. The probability of failure was 4.5% (95%CI 3.5%-5.6%, p<0.001). Additional treatments performed were Le Fort I (99 implants, 20 patients, 3.5% failed), grafting (497 implants, 77 patients, 5.2% failed), distraction osteogenesis (79 implants, 16 patients, 10.1% failed). Mean follow-up was 42.9±41.9 months (min-max, 2-240). Conclusions. Dental implants placed in ED patients, either infants or adults, present a high survival rate (20-year CSR 84.6%).

INTRODUCTION

Ectodermal dysplasia (ED) encompasses a number of genetic syndromes characterized by a congenital defect in two or more of the ectodermal structures of the body. The condition is estimated to occur in approximately 1 in 100,000 live births, and approximately 132 different hereditary syndromes related to ED have been identified (Clarke, 1987). The syndromes usually affect the hair, teeth, nails, sweat glands, craniofacial structures, digits, and occasionally mesodermal abnormalities (Clarke, 1987). The impact on the oral and maxillofacial region includes decreased growth of the mandible and maxilla, deficient development of the maxillary and mandibular alveolar ridges, significant reduction in salivary secretions, and malformations and anomalies of number and shape of primary and permanent teeth (Martin et al., 2005). As many of these patients present oligodontia (absence of 6 or more teeth) or anodontia (complete absence of teeth), a prosthetic rehabilitation is usually desirable. The degree of dentoalveolar tissue deficiency can make an implant-supported prosthesis an appropriate method of definitive occlusal restoration in these patients. However, as the absence of teeth is congenital, this raises the issue of placement of oral implants in growing children, mainly due to the influence of craniofacial growth on the implant’s behavior (Singer et al., 2012). The aim of the present review was to assess the clinical outcome and survival rate of oral implants used for the oral rehabilitation of ED patients.