J Dethlefs-Canto, S Baeza-Vallejos, D Ormeño-Sepúlveda, A Bustos-Ponce
{"title":"Strategies for rehabilitation management with implants in patients with down syndrome: a scoping review.","authors":"J Dethlefs-Canto, S Baeza-Vallejos, D Ormeño-Sepúlveda, A Bustos-Ponce","doi":"10.4317/medoral.27093","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Down Syndrome (DS), caused by an extra chromosome 21, has a prevalence of 24.7 per 10,000 live births in Chile, the highest in Latin America. Individuals with DS commonly present orofacial and dental anomalies, complicating oral health management. Many depend on removable prostheses, which represent challenges in hygiene, handling, and adaptation. Dental implants are a promising alternative, offering improved stability and functionality. However, successful rehabilitation requires addressing specific anatomical, physiological, and behavioral considerations. This scoping review compiles evidence-based strategies to guide implant treatment in this population.</p><p><strong>Material and methods: </strong>Registered on the Open Science Framework (https://osf.io/bstwk/), this review followed the PRISMA-ScR protocol, addressing the question: \"Which are the management strategies and survival rates of dental implants in patients with Down Syndrome?\" Searches were conducted in Pubmed/MEDLINE, Scopus, Science Direct, Web of Science, and Ebsco databases.</p><p><strong>Results: </strong>Of 92 studies identified, 7 met inclusion criteria, encompassing 179 implants in DS patients. Anesthesia type varied based on patient cooperation and procedure complexity: general anesthesia for uncooperative patients, local anesthesia for compliant individuals, and sedation for intermediate cases. Delayed loading (3-12 months) yielded better outcomes than immediate loading. Overdentures with locator or bar systems were effective and easier to maintain, while screw-retained fixed prostheses provided stability but required strict hygiene adherence. Clinical success rates varied, with higher success in simple cases and higher failure rates in studies involving multiple implants.</p><p><strong>Conclusions: </strong>Dental implants, combined with structured behavioral management, improve oral rehabilitation outcomes in DS patients. While sedation or general anesthesia may be required, associated risks must be carefully managed. Delayed implant loading is recommended to minimize osseointegration failures. An interdisciplinary approach, including material selection, caregiver education, and long-term maintenance, is essential for successful, individualized outcomes.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e561-e567"},"PeriodicalIF":2.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221154/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina Oral Patologia Oral Y Cirugia Bucal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4317/medoral.27093","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Down Syndrome (DS), caused by an extra chromosome 21, has a prevalence of 24.7 per 10,000 live births in Chile, the highest in Latin America. Individuals with DS commonly present orofacial and dental anomalies, complicating oral health management. Many depend on removable prostheses, which represent challenges in hygiene, handling, and adaptation. Dental implants are a promising alternative, offering improved stability and functionality. However, successful rehabilitation requires addressing specific anatomical, physiological, and behavioral considerations. This scoping review compiles evidence-based strategies to guide implant treatment in this population.
Material and methods: Registered on the Open Science Framework (https://osf.io/bstwk/), this review followed the PRISMA-ScR protocol, addressing the question: "Which are the management strategies and survival rates of dental implants in patients with Down Syndrome?" Searches were conducted in Pubmed/MEDLINE, Scopus, Science Direct, Web of Science, and Ebsco databases.
Results: Of 92 studies identified, 7 met inclusion criteria, encompassing 179 implants in DS patients. Anesthesia type varied based on patient cooperation and procedure complexity: general anesthesia for uncooperative patients, local anesthesia for compliant individuals, and sedation for intermediate cases. Delayed loading (3-12 months) yielded better outcomes than immediate loading. Overdentures with locator or bar systems were effective and easier to maintain, while screw-retained fixed prostheses provided stability but required strict hygiene adherence. Clinical success rates varied, with higher success in simple cases and higher failure rates in studies involving multiple implants.
Conclusions: Dental implants, combined with structured behavioral management, improve oral rehabilitation outcomes in DS patients. While sedation or general anesthesia may be required, associated risks must be carefully managed. Delayed implant loading is recommended to minimize osseointegration failures. An interdisciplinary approach, including material selection, caregiver education, and long-term maintenance, is essential for successful, individualized outcomes.
背景：唐氏综合症（DS）是由多余的21号染色体引起的，智利的患病率为每10000例活产婴儿中有24.7例，是拉丁美洲最高的。退行性椎体滑移患者通常存在口面和牙齿异常，使口腔健康管理复杂化。许多人依赖于可移动的假肢，这在卫生、处理和适应方面提出了挑战。牙种植体是一种很有前途的替代品，提供了更好的稳定性和功能。然而，成功的康复需要解决特定的解剖，生理和行为方面的考虑。这一范围审查汇编了基于证据的策略来指导这一人群的种植治疗。材料和方法：在开放科学框架（https://osf.io/bstwk/）上注册，本综述遵循PRISMA-ScR协议，解决问题：“唐氏综合征患者种植牙的管理策略和存活率是什么？”在Pubmed/MEDLINE、Scopus、Science Direct、Web of Science和Ebsco数据库中进行了搜索。结果：在确定的92项研究中，7项符合纳入标准，包括179名DS患者的种植体。麻醉类型根据患者的配合程度和手术的复杂程度而有所不同：不配合的患者采用全身麻醉，配合的患者采用局部麻醉，中度患者采用镇静。延迟加载（3-12个月）比立即加载效果更好。覆盖义齿的定位器或棒系统是有效的，更容易维护，而螺钉保留的固定义齿提供稳定性，但需要严格的卫生遵守。临床成功率各不相同，简单病例的成功率较高，而涉及多个植入物的研究失败率较高。结论：种植牙结合结构化行为管理可改善退行性椎体滑移患者的口腔康复效果。虽然可能需要镇静或全身麻醉，但必须仔细管理相关风险。建议延迟种植体加载以减少骨整合失败。跨学科的方法，包括材料选择、护理人员教育和长期维护，对于成功的个性化结果至关重要。
期刊介绍：
1. Oral Medicine and Pathology:
Clinicopathological as well as medical or surgical management aspects of
diseases affecting oral mucosa, salivary glands, maxillary bones, as well as
orofacial neurological disorders, and systemic conditions with an impact on
the oral cavity.
2. Oral Surgery:
Surgical management aspects of diseases affecting oral mucosa, salivary glands,
maxillary bones, teeth, implants, oral surgical procedures. Surgical management
of diseases affecting head and neck areas.
3. Medically compromised patients in Dentistry:
Articles discussing medical problems in Odontology will also be included, with
a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients.
4. Implantology
5. Periodontology
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