Saliva is critical to the health of our teeth, and as we usually have reduced saliva when living with Sjögren’s syndrome it can lead to many oral health problems, including cavities and gum disease. Sometimes there may be tooth loss, which makes people with Sjögren’s syndrome consider tooth replacement.
The same dry mouth conditions that lead to tooth loss could potentially lead to dental implant failure. However, a new study shows that people with this condition might actually have very good long-term results with dental implants.
Sjogren's “It is known to reduce the saliva flow, resulting in a dry and very sensitive oral mucosa. Patients may more rapidly lose their teeth caused by caries and periodontitis compared with patients who are not affected by this disease,” said co-author Dr Ann Wennerberg from the Department of Prosthodontics at Sahlgrenska Academy at the University of Gothenburg.
“The very small amount of saliva results in a lack of necessary lubrication,” continued Wennerberg. She explained that this would cause the patient soreness and pain. “For patients with Sjögren’s syndrome removable dentures may be impossible to wear,” she added. As a result, many affected patients turn to dental implants.
HOW THE STUDY WAS DONE:
The researchers conducted the study in two parts. First, they reviewed a clinical series of 19 Sjögren’s patients who, together, had received 107 dental implants. Second, they conducted a review of published literature and assessed the cases of 186 patients who had received a total of 712 implants, of which 705 were followed up.
Through the clinical series, the researchers found that, out of 19 patients, two patients lost three implants, together, which led to a failure rate of 2.8 per cent. All failed implants were caused by a lack of osseointegration.
Osseointegration is “the formation of a direct interface between an implant and bone, without intervening soft tissue”.
The implants were followed for ten years. At the last follow-up, the mean marginal bone loss for patients was -2.19 mm. The research team estimated the marginal bone loss after 30 years at 4.39 mm.
From the literature review, the researchers found that, out of the 705 implants—which were followed up for approximately six years—29 failed, resulting in a failure rate of 4.1 per cent. After conducting statistical analysis, researchers found that the probability of failure was 2.8 per cent.
THE RESULTS SHOW:
- that a treatment with dental implants can be done with a good prognosis, in contrast to what has been feared.
- the marginal bone resorption to be higher than for patients without Sjögren’s syndrome.
- those with primary Sjögren’s syndrome had a lower failure rate of implants of 2.5 per cent compared with patients with secondary Sjögren’s syndrome. These patients showed a failure rate of 6.5 per cent.
- This indicates the need for regular visits to the dentist and short intervals between appointments.
SOURCE: Dental Tribune
STUDY: Dental implants in patients with Sjögren’s syndrome: A case series and a systematic review published 2019 in the International Journal of Oral and Maxillofacial Surgery