It has been predicted that there will be an increase in the proportion of people older than age 80 by the year 2020.¹ Most elderly people are healthy and active, and many are seeking dental care to improve their oral function as they continue to age (Figure 17-1). Over the past decade, the number of patients presenting with more teeth and fewer prostheses has increased. This trend is the result of increased emphasis by dental professionals on prevention and the need for patients to improve their oral hygiene practices.² However, the prosthodontic needs of elderly patients are extensive, and these patients will expect to maintain high standards of oral function.¹

FIGURE 17-1 ▪ As more senior citizens live healthier and longer lives, the need for oral care and treatment has increased.

The use of removable dentures does not allow for adequate oral function in many geriatric patients, and these patients may have difficulty adapting to full dentures (Figure 17-2). Firmly retained, functional prostheses should be used in these patients for physiological and psychological reasons, as well as for the role that adequate oral function plays in proper digestion and nutrition.¹ Patients who do not receive adequate oral rehabilitation to improve function and esthetics may withdraw from society and experience a loss of self-esteem.²

FIGURE 17-2 ▪ The use of partial dentures is very common in geriatric patients.

Dental implants and implant-supported prostheses have been used successfully in geriatric patients (Figure 17-3). In a study of implant placement in elderly patients, Kondell et al found that the success rate was similar to that found when implants were placed in younger patients.¹ However, a single type of implant is not appropriate for all patients. The size, shape, quality, and quantity of bone are different in each patient. Clinicians who place dental implants in elderly patients must be aware of the systemic influences that affect alveolar bone and must understand bone physiology, metabolism, and the response of alveolar bone to systemic changes. It is important for clinicians to understand that alveolar bone responds similarly to systemic challenges as bone in other skeletal sites. Factors related to initial integration of the implants, such as maintaining vital osseous peri-implant margins, preserving subperiosteal osteogenic capacity, and stabilizing the implant firmly within bone, can be affected by the status of the alveolar bone and its associated structures.³

FIGURE 17-3 ▪ Implant-supported prosthesis with a bar.