Dental implants in OI
Interview with Dr. Ole Oelerich, Dentist at the Department for Prosthodontics and Biomaterials,
University Hospital in Münster, Germany
Who are you & what is your relationship to OI?
My name is Dr. Ole Oelerich, I am a Dentist at the Department for Prosthodontics and Biomaterials at the University Hospital in Münster, Germany. After completing my doctoral thesis on oral health-related quality of life (OHRQoL) of people with Ehlers-Danlos syndromes under the supervision of Dr. Marcel Hanisch, I wanted to expand my knowledge and focus my research on rare diseases and their impact on oral health. My goal is to provide scientific data to other researchers and advance the knowledge of rare diseases, because I think knowledge is one of the most important steps to improve the treatment and detection of rare diseases.
Who was behind the dental implant & OI project?
The project began when a patient with OI Type I needed an implant-supported prosthesis in 2019 and turned to Dr. Hanisch for help. He was able to treat the patient with a great outcome, but found that data on dental implants for people with OI was very sparse. You can find the case report here. He asked me if I would be interested in conducting a systematic review on the topic, so I started to work on gathering data in August 2021.
Which methods were used and how was it financed?
I conducted a search in three of the largest scientific databases to find all case reports or studies in which people with OI were treated with dental implants. After collecting all the studies, we systematically analyzed each report to find out whether dental implants can be a safe and reliable method to replace missing teeth in people with OI. The research received no external funding and was entirely self-funded.
What was your research project about?
Since OI affects bone density and quality, we expect dental implants to have a lower survival rate compared to individuals not affected by OI. In addition, it must be considered that the usual therapy with bisphosphonates may further influence the survival rate of dental implants. Implant survival is defined as when the implant has fully healed after insertion into the bone, has formed a stable bond with the bone, and a crown or prosthesis can be placed on top of it.
We found a total of 12 case reports that dealt with the treatment of people with OI with dental implants. In all these scientific reports, 46 people with OI were treated with a total of 116 dental implants. In daily dental practice, the survival rate of implants is about 98%. Our systematic review found an implant survival rate of 94% in people with OI. This means that of the 116 implants placed, only 7 implants failed to integrate properly into the bone and could not be used for a crown or prosthesis. The whole systematic review can be accessed here.
What have been your most interesting findings so far?
The main conclusion of our systematic review is that dental implants can be a safe and reliable method to replace missing teeth for people with OI and should definitely be considered by dentists. Another interesting result of our investigation is the survival of all immediately loaded implants in the reports we found. This means that the implant receives a crown or prosthesis immediately after insertion and can thus immediately replace missing teeth. Traditionally, implants were left without a restoration on them for the first months. Nowadays, more and more implants are loaded immediately, and it was nice to see that this treatment option seems to have great success also in people with OI.
What is the most important take home message for clinical work?
The most important message is that dentists should consider treating missing teeth with dental implants more often in people with OI. If they choose to do so, it is important that they publish their results to add to the available data on implant survival.
Of course, the individual risks must be carefully weighed in each case, but the data clearly show that dental implants can achieve great results.
Did you have patient involvement?
Our systematic review was solely a collection and statistical analysis of all existing articles dealing with dental implants for people with OI. No patients were involved in this part. However, we hope to assist dentists in deciding whether dental implants may be an option for treating their patients with OI with missing teeth.
Do you have any final messages for the readers of OIFE Magazine?
I am grateful for the opportunity you have given me to present our results, and I really hope that our research can help people with OI in the future when they are presented with the need to replace missing teeth. I will continue my research and hope that we can further improve the treatment of people affected by rare diseases.
This article was first published in OIFE Magazine 1-2022, which can be downloaded for free here.