Existe influência da idade na sobrevida e complicações de implantes dentários? Uma revisão sistemática e meta-análise

Abstract

Although dental implants have become established as one of the main alternatives for oral rehabilitation, the success of this treatment depends on risk factors that can compromise its clinical predictability. In the Brazilian context, the accelerated aging of the population demands a greater understanding of the effectiveness of implants in elderly patients, since senescence is associated with changes in bone density, the presence of systemic comorbidities, and the use of medications that can interfere with the osseointegration process. This systematic review with meta-analysis, conducted according to the PRISMA 2020 guidelines, aimed to evaluate the influence of age on survival outcomes, marginal bone loss, and the occurrence of complications in dental implants. The bibliographic search was carried out in the MEDLINE, Scopus, Web of Science, Cochrane, and Embase databases, complemented by a manual search in the grey literature. Studies with a minimum follow-up of one year that compared elderly (≥ 60 years) and non-elderly (< 60 years) patients were included. The selection of studies and data extraction were performed independently by two reviewers using the Rayyan QCRI platform, and the certainty of evidence was assessed using the GRADE system. Fourteen studies were included, totaling 3,313 patients and 8,143 implants, of which 2,518 were placed in elderly patients and 5,625 in the control group. The meta-analysis demonstrated that the implant survival rate in elderly patients was similar to that observed in younger patients with an Odds Ratio [OR] = 0.73; 95% confidence interval [95% CI]: 0.50–1.07; p = 0.45. Similarly, no statistically significant differences were observed in marginal bone loss between the groups ([OR]: −0.08; 95% CI: −0.30 to 0.13; p = 0.45). Thus, the results indicate that age, in isolation, does not exert a significant influence on the clinical effectiveness of dental implant treatment.