Immediate loaded full-arch maxillary rehabilitations in younger vs elderly patients: a comparative prospective study with 6-year follow up

Aim The aim of this prospective comparative study was to assess whether age has an influence on implant survival in patients treated with implants rehabilitated according to the All-on-4 treatment concept.

Materials and methods A prospective study was performed with two edentulous patient groups: a younger group (n = x; average age 45 years, 35-50 years) and an older group (n = x; average age 68 years, 60-80 years). Implant and prosthetic failure, biological prosthetic complicance, peri-implant marginal bone level changes for survival rates. To compare marginal bone levels between younger and older patients groups at 6 months and yearly until the 6-year follow-up, Student's t-tests were applied at a significance level of p < 0.05.

Results Fifty-four patients met the eligibility criteria and were included in the study among 78 patients screened; a total of of 216 implants were placed in 54 patients (table 1) and, in total, 54 “all-on-four” rehabilitations were delivered. Implants failure was registered in four patients (4 of 216 fixtures), 2 in YG patient and 2 in a OG; So, an implant failure rate of 1.85% was reported in each group. Peri-implantitis was observed in 7 of 216 implants (3.24%) and 4 of 54 patients (7.41%) (2 from YG and 2 from OG) at the 6-year follow-up. At the 6-year radiographic evaluation, peri-implant crestal bone loss averaged 1.01 ± 0.93 mm for OG and 0.85 ± 1.04 mm for YG. Three of 54 fixed provisional prostheses were fractured during the observation period, representing a prosthetic survival rate of 94.45%

Conclusion At 6 years of follow-up the significant statistical difference in outcome measures between the two groups is not significant so all-on-4 rehabilitation is indicated in elderly patients in order to improve their quality of life.