Dental implants are a viable option for people with Sjogren’s syndrome, but these patients may experience a higher marginal bone loss around their implants than patients from the general population, a study shows.
The study, “Dental implants in patients with Sjogren’s syndrome: a case series and a systematic review,” was published in the International Journal of Oral & Maxillofacial Surgery.
Sjogren’s syndrome is a systemic disease characterized by the progressive destruction of some glands, particularly those around the eyes and mouth. As a result, people with Sjogren’s syndrome have dry eyes and mouth, poor oral health, with complications such as reduced salivary flow and caries (decay and crumbling of a tooth or bone), and chronic inflammation.
As Sjogren’s syndrome patients are more susceptible to the development of caries, they lose many teeth during their lifetime. Dentures are often difficult to wear because of the dry and sensitive mucosa, so many patients turn to dental implants.
However, it is not yet known whether dental implants are successful in Sjogren’s patients. In fact, many professionals advise against them, as they believe these patients have a higher risk of implant failure.
Therefore, a group of Swedish researchers set out to assess the clinical outcomes of dental implants in patients with Sjogren’s syndrome.
They conducted the study in two parts. First they reviewed a clinical series of 19 Sjogren’s patients who, together, had received 107 dental implants. Next they conducted a review of already-published literature and assessed the cases of 186 patients who had received a total of 712 implants (705 implants were followed up upon).
Through the clinical series, researchers found that out of 19 patients, two patients lost three implants, which led to a failure rate of 3/107 or 2.8%. All failed implants were due to lack to osseointegration — direct structural and functional contact between the bone and the implant.
The implants were followed for a mean period of 10 years; at the last follow-up, the mean marginal bone loss for patients was -2.190 mm, with one-quarter of implants having a marginal bone loss of over 3 mm.
From the literature review, researchers found that out of the 705 implants, 29 failed, a failure rate of 4.1%. After conducting statistical analysis, researchers found that the probability of failure was 2.8%.
Additionally, researchers found that most implant failures (79%) occurred within six months after installation, which is consistent with already-published literature.
When stratifying patients based on primary or secondary Sjogren’s syndrome, researchers found that those with primary disease — when the condition happens on its own — had a lower failure rate of implants (2.5%) compared to patients with secondary Sjogren’s syndrome — when the disease is caused by pre-existing conditions. They had a failure rate of 6.5%.
Researchers added that patients reported a significant improvement in their quality of life after dental implants, with improvements regarding satisfaction, appearance, and ability to eat.
Therefore, “dental implants should be considered by dentists as a viable treatment option for patients with [Sjogren’s syndrome], as the failure rate is fairly low. Patients may, however, present a higher [marginal bone loss] around implants than patients from the general population,” researchers concluded.