Dental implants are medically advisable for patients with Sjögren’s syndrome
MALMÖ/GOTHENBURG, Sweden: Up until now it was not known whether dental implants were successful in patients affected by Sjögren’s syndrome. In fact, many professionals advise against them, as they believe these patients have a higher risk of implant failure. However, researchers at the universities of Malmö and Gothenburg in Sweden have found that dental implants are a viable option for people with Sjögren’s syndrome, even though these patients may experience a higher marginal bone loss around their implants than others.
Sjögren’s syndrome is a systemic disease characterised by the progressive destruction of some glands, particularly those around the eyes and mouth. “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.
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. The implants were followed for a mean period of 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.
When stratifying patients based on primary or secondary Sjögren’s syndrome, the researchers found that those with primary disease 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.
“The results show that a treatment with dental implants can be done with a good prognosis, in contrast to what has been feared. However, the results also demonstrate the marginal bone resorption to be higher than for patients without the syndrome. This is indicative for the need for regular control visits to the dentist and short intervals between appointments to a dental hygienist,” concluded Wennerberg.
The study, “Dental implants in patients with Sjögren’s syndrome: A case series and a systematic review”, was published online on 1 March 2019 in the International Journal of Oral and Maxillofacial Surgery, ahead of inclusion in an issue.