Progress in medical and dental clinical practice fosters treating even very old geriatric patients with implants. Very few absolute contraindications remain nowadays, and the long-term performance of endosseous implants has largely exceeded initial expectations. In contrast to the environment in which they are placed, implants do not change. In view of the aging population, a paradigm shift in implant dentistry seems inevitable.
Physiological aging is featured by deterioration in vision, tactile sensitivity, and dexterity, rendering denture handling and oral hygiene difficult. In addition, old people often present with frailty and multimorbidity, often requiring assistance with the activities of daily living and a shift in life priorities.
When additional tooth loss occurs, a new restorative treatment is required. Although it is well accepted that age alone is not a contraindication for successful implant therapy, it is increasingly necessary to consider its implications in a geriatric treatment planning.
Monitoring the use and management of fixed and removable implant prostheses in geriatric patients seems mandatory. When functional decline and frailty render denture management difficult, “backing off” to a simplified and less complex restoration with or without the present implants may become necessary.
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The text of this chapter is largely based on the International Team of Implantology Treatment Guide 9, Implant therapy in the Geriatric Patient (Quintessence, Berlin, 2016).
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