Early experience of implant-supported prostheses in patients with neurologic disabilities.

PURPOSE: The purpose of this prospective study was to provide a preliminary report of implant treatment in patients with neurologic disabilities.
MATERIALS AND METHODS: Patients had been referred to the National Orofacial Resource Centre with different disabilities, specifically neurologic disorders causing various orofacial dysfunction problems, and were suitable for prosthodontic treatment with implants. Patients were treated with single implant-supported crowns, fixed partial dentures, or complete implant-supported dentures. Implants used were threaded titanium cylinders placed under general or local anesthesia. All surgical complications in the healing period or at second-stage surgery were noted, as were all prosthodontic complications.
RESULTS: Fourteen patients were treated with 35 implants. Three implants were lost before or at second-stage surgery, and two implants were lost after loading. These complications were observed in two patients. Implant failures and other complications were observed in two patients in the mandible because of dehiscence of the mucoperiosteal flap and infection. Some patients had developed finger or oral habits, such as excessive tongue movements, that were probably responsible for these complications. One of the patients with Down syndrome possibly had reduced resistance to infections. No major complications were observed for the other 12 patients treated.
CONCLUSION: Strict adherence to a surgical protocol is needed for the management of patients with neurologic disabilities. It is important to inform the patient's caregiver about maintenance of good oral hygiene and the increased risk of complications caused by finger or oral habits.