Approaches to Preoperative Assessment of Elderly Patients Undergoing Dental Surgical Interventions: A Systematic...

Elderly patients represent a high-risk population for surgical dental interventions due to multimorbidity, frailty, and polypharmacy. Moreover, standard preoperative assessment protocols often fail to account for geriatric syndromes. Objective: To systematize and analyze contemporary approaches and tools for comprehensive preoperative assessment of elderly patients planning surgical dental procedures.

A systematic review was conducted in accordance with the PRISMA 2020 guidelines. The review protocol was registered in the international PROSPERO registry (ID: CRD420251147418). Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Google Scholar, CyberLeninka, and eLibrary.ru up to January 31, 2025. Original studies including patients aged 60 years focused on preoperative assessment prior to dento-maxillofacial surgery were included. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using the ROBINS-I tool for observational studies.

Of 312 identified records, 12 studies were included in the analysis. The most frequently evaluated domains were nutritional status (MNA, MNA-SF; 5 studies), cognitive function (Mini-Cog, MMSE; 5 studies), frailty (Fried Criteria, CFS; 6 studies), and oral health (CPI, PI, OHIP-14; 8 studies). Meta-analysis was not performed due to high clinical and methodological heterogeneity. Overall evidence quality, assessed using the GRADE system for key outcomes, was low, confirming methodological limitations in the current scientific literature in geriatric dentistry.

Despite the availability of numerous geriatric assessment tools, a standardized preoperative protocol for dental surgery is lacking. The findings emphasize the need for development and validation of a dental-specific assessment algorithm based on comprehensive geriatric assessment (CGA). Limitations: The conclusions should be interpreted with caution due to methodological limitations of the included studies, their heterogeneity, and inclusion of general maxillofacial surgery data, which reduced specificity for dental practice. Risk of publication bias was not assessed.