Pavăl Daniel, Norina Forna, Claudiu Topoliceanu, Murariu Alice
DOI : 10.62610/RJOR.2026.2.18.12
Abstract
Objectives. The aim of this narrative review was to evaluate the current evidence on the predictability of success and failure in prosthetic and implant-prosthetic rehabilitation of edentulous patients in relation to systemic pathology. Materials and Methods. A structured literature search was conducted in PubMed/MEDLINE, PubMed Central, Scopus, and Web of Science. Systematic reviews, meta-analyses, randomized controlled trials, and cohort studies published between 2000 and 2025 were included. Outcomes of interest were implant survival rate, implant success rate, marginal bone loss, peri-implantitis prevalence, and prosthetic complication rates. Data were synthesized narratively due to heterogeneity across included studies. Results. Partial edentulism clusters strongly with diabetes, cardiovascular disease, and obesity. Systemic conditions — including diabetes mellitus, cardiovascular disease, rheumatoid arthritis, SLE, and osteoporosis — amplify periodontal dysbiosis, impair immune competence and microvascular integrity, and accelerate alveolar bone destruction, thereby compromising the prognosis of both tooth-supported and implant-supported prosthetic rehabilitations. The conceptual framework has shifted from categorical contraindication toward individualized risk stratification, with most systemic conditions representing relative rather than absolute contraindications, and treatment predictability being primarily determined by disease control status rather than diagnosis alone. Conclusions. Systemic comorbidities represent predominantly relative rather than absolute contraindications for prosthetic and implant-prosthetic rehabilitation. Long-term treatment predictability is modulated by disease control status rather than the mere presence of a systemic condition, underscoring the need for individualized risk stratification and multidisciplinary management prior to and during prosthetic rehabilitation.
Loading...
Reload document 
Open in new tab