Upper age limit for dental implant treatment?

Having placed in 90 year old , they have been suprisingly good patients , intergration and graft wise and are less prone to the the poor OH issues you would expect in thse situations . Crown and bridge work is more prone here to root decay. But this is more complicated and a lot of patient discussion is need to find the best path for this case Peter

Geriatric age is generally considered a relative contraindication to dental implants. Every provider has a different age level at which they begin to strongly suggest other treatment options. I personally begin to draw the line at any healthy patient older than 80 years old. My reasoning is the investment of 6-12 months of healing time and temporization of the implant site becomes significant in comparison to the amount of time the implant will eventually function. The average lifespan is around 80. Although many live to 90, 100, and beyond, it is unpredictable. A bridge or partial denture can typically be fabricated in a significantly shorter period of time and save an older patient a period of frustration during temporization.

I disagree, if the patient wants a conservative implant placed in a carious non infected area I would actually do an immediate placement then restore it in 4-6 months depending on the insertion torque. My oldest patient is a healthy 90 year old who's wife insisted on it. This will make the patient very happy vs telling him he is too old. I know we are told to number our days but in this case I would make the patient happy, if he gets a year or more out if it great the adjacent are not good candidates for abutments which would probably need a lot of heroic work and don't make a partial for one tooth. Mentally an implant would be good since the patient is not losing a tooth but will have " one of those fancy new implants" to replace it and can show his family and friends. Eating is very important to this age group which I really enjoy treating. The argument could also be made that anyone of us could not be here tomorrow so make the best if each day which is a blessing!

Dear CRS I'm the poster and that's what my thinking is. Say if it was my grandfather I would recommend him implant vs bridge or denture. If he was taking meds, had any health problems then risks would outweight benfits but he is fully consented so I will probably do it. My plan is immediate actually. Simon Milbauer

A single implant-supported crown will not significantly improve the patient mastication in this case. If the left side has any defect, a removable denture with metal frame is the best choice.

Age shouldn't really be the issue. Only the clinical problem and his general health and fitness. Why would anyone deny someone treatment just because of the opine of being considered too old???

I do not see any problem with treating thisnpatient via implant dentistry. The bone may be compromised due to age. Just proceed slowly.

Took impressions last week,for 2 NobelActive implants for right upper bicuspids on a 92 year older retired American judge. Her request she came just for the implants after relocating from Phoenix, it was aesthetics and function, $ was not an issue. She is extremely healthy and could pass next year or in ten years, but she will be smiling and chewing without feeling old with teeth she puts it's in a glass at night. She did not want removables, who of us really would given the choice.

I agree with all who support placing the implants. As my grandfather and my father have told me, the joy of mastication and eating is the only thing that remains at that age. Clean the calculus on the molar and place the two implants immediately and he will be fine. I have worked on 93+ pts and they were all happy that they received their implants right away and were restored in 3-4 months. They don't have much time and limiting their surgical visits is good practice.

I think others may agree with this statement- "Send him to my office, I'll place the implant...." Age should be no reason not to, especially as he's healthy. My oldest placement has been 93 and she's now 97 and still doing fine....

Who are we to judge whether someone is too old for an implant. He wants it and if he was 60 we wouldn't be asking the question. He's healthy and it's an ideal site, in a willing patient. The average time it will function for is irrelevant. This guy could live another 10 or more years...who knows. Slam dunk case really:-)

At that age, every day count , he is loosing days of good mastication while we are discussing this matter. 12 years ago I did my oldest implant patient , he was 100 years old at that time and had severe problems to eat. Of course he is not around any more , but their immediate load implants did last for the rest of his life ( 4 years ). Today there are good implant options to do and restore the case in a faster and safe way. Also do it flapless. I did an implant case in a 38 years old men, he die in an accident before the implants could be uncovered. We don´t know the future , live the present......

Every day does count. So, don't put a foreign body in a dirty environment. I'm pretty certain this guy will be able to chew without this implant. Bvinci

Branemark said: "no one should die with their teeth in a glass" even if older than 90 years . The patient ask you and in good condition of general health and fitness why not implants?

The problem has been shifted to the patient age, but not to functional rehabilitation. This defect is too large for a single implant and I’m sure its value will be questionable.

He may well be able to chew but the reason for placement may be an aesthetic one...what's wrong with looking good and taking care of your appearance at 93. Nothing wrong with that.

I'm sure the patient can live without the gap. But look at the original post. He doesn't want a gap. So that leaves denture, bridge, or implant. He has already mentioned he wants an implant.

I'm sure the patient can live without the gap. But look at the original post. He doesn't want a gap. So that leaves denture, bridge, or implant. He has already mentioned he wants an implant. Give him the implant!

Couldn't agree more Pynadath. I have seen patients a lot younger than this, with poorer oral hygiene and starting off in a lot worse condition. I don't see why this case 'reeks of failure'? All patients, young or old go through an oral hygiene regime etc. in the usual way and actually the gum health in the photos doesn't look too bad...pink gums but soft plaque. We cannot dictate or generalise about what the patient would or would not want. He has come in asking for an implant as he doesn't want a gap there if the tooth is extracted. I'd place the implant after a full discussion, consent etc. as I would do with all patients.

Dear colleagues thank you very much for all the wise comments and advice. I have discussed the treatment options with this patient in depth and I am confident that he is sufficiently consented. He wishes me to replace the missing teeth with implant borne restoration as he simply doesnt want a gap. Therefore I am going ahead with implant treatment. Simon Milbauer

Nice one Simon. The general consensus on this thread is to offer the implant. I'm sure the treatment will go well and the patient will be happy:-)

I don't see much space between the root and the surrounding bone. Could be ankylosis so the immediate placement plan might get sidetracked into other options. Other than that possibility, I agree that placing the implant as per the patient's wishes is the correct action to take.