Region Jnkpings ln Odontologiska Institutionen
plus.rjl.se/oi

Dental implants in cerebral palsy

Bergendal B
 

Aim

25 years with excellent long-term clinical results. But very liDental implant treatment has been successfully carried out for ttle is known about outcomes and side-effects in individuals with rare disorders, mental disabilities, and chronic diseases - only two patients with cerebral palsy (CP) have been reported in the literature. These reports indicate that implants can be successfully placed and maintained, on condition that the patient adheres to a strict maintenance care programme and the patient's caretaker has been informed about the importance of good oral hygiene. The aim of this pilot study was to retrospectively evaluate experiences of oral rehabilitation with single tooth implants in individuals with cerebral palsy (CP) in Sweden.

Material and Methods

A questionnaire on treatment with single tooth implants in persons with CP was sent to 12 specialists in prosthetic dentistry. The questions aimed to collect information on reason for tooth loss, need for general anaesthesia and sedation, compromises compared to ordinary treatment, and complications, especially loss of implants.

Results

All 12 specialists answered the questionnaire. Treatment had been performed at five centres in 11 individuals with CP and missing front teeth: 6 females and 5 males, born between 1966 and 1988. Nine (82%) had CP and a learning disability. Anterior tooth loss in 10 patients was due to trauma - often falling out of the wheel chair - and in one patient to tooth agenesis. Usually surgery, and sometimes all treatment, was performed under general anaesthesia or sedation. Nineteen implants were placed, 16 in the maxilla and 3 in the mandible. One was lost shortly after placement and reinstalled after one year. All implants and single tooth replacements were in service at the time of the inquiry.

Conclusion

This pilot study found promising treatment outcomes with frontal single tooth implants in individuals with CP. The dominating reason for loss of front teeth was trauma because of falls. Treatment indications were social and aesthetic and treatment was often strongly desired by the family. The ethical dilemma in treating persons who have no say of their own is one of the challenges of treatment planning in this group of individuals. Need for maintenance care and the long teerm results of treatment with dental implants in patients with CP ought to be further investigated.

Uppdaterad: 2013-04-03
Anna Thofelt, Avdelningen för odontologisk radiologi Jönköping, Folktandvården