A review of the outcome of dental implant provision in individuals with movement disorders

Movement disorders encompass a wide range of medical conditions that demonstrate changes to muscle function and tone which present with orofacial dyskinesia and dystonia. The most common conditions exhibiting these features are Parkinson's disease, Down syndrome, chorea and epilepsy. Aim: To establish whether implant success in patients suffering from movement disorders is similar to the general population, identifying risk factors and noting recommendations that may aid maintenance programmes. Method: PubMed and Medline searches, combined with a manual search of the reference lists of identified full text studies. In total, 19 patient case reports and 11 patient case series were identified for inclusion in the review. Results: Implant survival in patients may be less than expected in patients with movement disorders, but evidence points to early rather than late failures. Oral hygiene control was widely reported as an issue, although there was insufficient evidence to imply that a lack of oral care will cause more rapid deterioration in implant patients with movement disorders. Maintenance requirements were low for fixed restorations, but more frequently reported in patients treated with overdentures, with the attachment mechanism and the prostheses requiring replacement. Chewing and quality of life in relation to prosthesis wear were improved. Conclusion: Provision of implant-supported prostheses improves chewing and quality of life for patients with movement disorders and should be considered as an option in the treatment planning for tooth loss in this group of patients. However, straightforward designs that lend themselves to easier long-term maintenance should be adopted. Keywords: dental implant, Down syndrome, dyskinesia, dystonia, epilepsy, implant outcome, movement disorder, Parkinson's disease