Objectives: his review evaluated implant survival in geriatric patients (≥75 years) and/or the impact of systemic medical conditions. Materials and Methods: Systematic literature searches were performed to identify studies reporting on geriatric subjects with dental implants and on implant patients who had any of the seven most common systematic conditions among geriatric patients. Meta‐analyses were performed on the postloading implant survival rates. The impact of systemic medical conditions and their respective treatment was qualitatively analyzed. Results: A total of 6,893 studies were identified; of those, 60 studies were included. The fixed‐effects model revealed an overall implant survival of 97.3% (95% CI : 94.3, 98.7; studies = 7) and 96.1% (95% CI : 87.3, 98.9; studies = 3), for 1 and 5 years, respectively. In patients with cardiovascular disease, implant survival may be similar or higher compared to healthy patients. High implant survival rates were reported for patients with Parkinson's disease or diabetes mellitus type II . In patients with cancer, implant survival is negatively affected, namely by radiotherapy. Patients with bone metastases receiving high‐dose antiresorptive therapy ( ART ) carry a high risk for complications after implant surgery. Implant survival was reported to be high in patients receiving low‐dose ART for treatment of osteoporosis. No evidence was found on implant survival in patients with dementia, respiratory diseases, liver cirrhosis, or osteoarthritis. Conclusions: Implant prostheses in geriatric subjects are a predictable treatment option with a very high rate of implant survival. The functional and psychosocial benefits of such intervention should outweigh the associated risks to common medical conditions.

This is an expert opinion paper on oral health policy recommendations for older adults in Europe, with particular focus on frail and care‐dependent persons, that the European College of Gerodontology ( ECG ) and the European Geriatric Medicine Society ( EUGMS ) Task and Finish Group on Gerodontology has developed. Oral health in older adults is often poor. Common oral diseases such as caries, periodontal disease, denture‐related conditions, hyposalivation, and oral pre‐ and cancerous conditions may lead to tooth loss, pain, local and systemic infection, impaired oral function, and poor quality of life. Although the majority of oral diseases can be prevented or treated, oral problems in older adults remain prevalent and largely underdiagnosed, because frail persons often do not receive routine dental care, due to a number of barriers and misconceptions. These hindrances include person‐related issues, lack of professional support, and lack of effective oral health policies. Three major areas for action are identified: education for healthcare providers, health policy action plans, and citizen empowerment and involvement. A list of defined competencies in geriatric oral health for non‐dental healthcare providers is suggested, as well as an oral health promotion and disease prevention protocol for residents in institutional settings. Oral health assessment should be incorporated into general health assessments, oral health care should be integrated into public healthcare coverage, and access to dental care should be ensured.

Objectives: The aim of Working Group 4 was to address topics related to biologic risks and complications associated with implant dentistry. Focused questions on (a) diagnosis of peri‐implantitis, (b) complications associated with implants in augmented sites, (c) outcomes following treatment of peri‐implantitis, and (d) implant therapy in geriatric patients and/or patients with systemic diseases were addressed.Materials and methods: Four systematic reviews formed the basis for discussion in Group 4. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary.Results: Bleeding on probing (BOP) alone is insufficient for the diagnosis of peri‐implantitis. The positive predictive value of BOP alone for the diagnosis of peri‐implantitis varies and is dependent on the prevalence of peri‐implantitis within the population. For patients with implants in augmented sites, the prevalence of peri‐implantitis and implant loss is low over the medium to long term. Peri‐implantitis treatment protocols which include individualized supportive care result in high survival of implants after 5 years with about three‐quarters of implants still present. Advanced age alone is not a contraindication for implant therapy. Implant placement in patients with cancer receiving high‐dose antiresorptive therapy is contraindicated due to the associated high risk for complications.Conclusions: Diagnosis of peri‐implantitis requires the presence of BOP as well as progressive bone loss. Prevalence of peri‐implantitis for implants in augmented sites is low. Peri‐implantitis treatment should be followed by individualized supportive care. Implant therapy for geriatric patients is not contraindicated; however, comorbidities and autonomy should be considered.

This study compared the clinical time spent and the costs incurred whilst constructing complete dentures (CDs) using a two-visit digital-denture protocol with the conventional complete denture protocol, in a university setting. Twelve undergraduate final-year dental students utilized both the digital denture protocol and the conventional complete denture protocol to construct two sets of CDs for patients requiring either an upper CD opposing a partial natural dentition restored using a partial removable prosthesis [Group#1: students: n = 6, upper CD: n = 12 (6-digital complete dentures +6-conventional complete dentures)] or both upper and lower CDs [Group#2: students: n = 6, upper and lower CDs: n = 24 (12-digital complete dentures+ 12-conventional complete dentures)]. Overall time spent and costs (clinical, materials, and laboratory) were calculated. A cost minimization analysis was performed to compare the economic costs of the two protocols. Paired t-tests were applied for the statistical analyses (p < 0.05). Conventional complete denture protocol required longer clinical time than digital complete dentures for both Group#1 (p = 0.0206) and Group#2 (p = 0.0020). The materials costs were higher for the digital complete dentures in both groups (Group#1 p < 0.0001; Group#2: p = 0.0002). The overall costs, were significantly higher for the conventional complete denture protocol than for the digital denture protocol (Group#1: p = 0.0032; Group 2: p = 0.0080). In a university setting student clinic in Geneva in Switzerland, the digital denture protocol is less costly when compared with the conventional complete denture protocol. The costs for clinical chairside time, laboratory and the overall costs were significantly lower for the digital denture protocol, even though the materials costs for this protocol were higher. The digital denture protocol might prove highly beneficial to the elderly and/or the compromised edentulous patient, as it can help decrease the treatment burden on the patient by reducing the clinical procedures, number of visits, treatment time and incurred costs.