Early dental implant failure: risk factors

The objective of this prospective study was to estimate the incidence of early loss of dental implants and the potential risk factors. The predictive variables were classified as being patient, implant, anatomical, or operation-specific. The outcome variable was early failure of the implant. The significance of differences was assessed using bivariate analyses, and then a multivariate logistic regression model to identify independent predictors for early loss of implants. A total of 169 patients, 116 women and 53 men, mean age 47 (range 16-80) years, had 399 implants inserted. Fifteen implants were lost in 14 patients (8%). The early loss of dental implants was significantly associated with width of keratinised gingiva (p=0.008), the use polyglactin sutures (p=0.048), and the use of narrow implants (p=0.035). Multivariate logistic regression analysis established the significance of narrow keratinised gingiva (OR=4.7, p=0.005) and the use of polyglactin sutures (OR=3.8, p=0.042), which we conclude are probably the strongest predictors of early failure of implants.     

Analysis of fractured dental implant body from five different implant systems: a long-term retrospective study

The aim of this study was to perform an analysis of the incidence of implant body fracture and to identify possible risk factors. A long-term follow-up retrospective evaluation of 3477 patients who received 8588 implants from five implant systems was performed. Overall, 2810 patients who received 7502 implants, with an average follow-up of 6.9 years, were included in the analysis. The overall body fracture rate was 0.49% (37/7502), among which 32.4% (12/37) were implants with a reduced diameter. The estimated cumulative fracture rate was 1.24%. Fractures were observed in two patients with three Brånemark implants, 13 patients with 15 Nobel Replace implants, eight patients with eight Camlog implants, eight patients with 11 Ankylos implants, and none of the patients with Thommen implants. Most fractures occurred in the molar region (29/37) and in single implant-supported restorations (30/37). The results showed significant differences between splinted and unsplinted restorations (P = 0.005) and between regular and narrow diameter implants (P = 0.009). Within the limitations of this retrospective analysis, a narrow implant diameter is a potential risk factor for implant body fracture in the posterior region. Furthermore, unsplinted restorations appear to be associated with a higher rate of implant fracture.     

COVID-19 as a factor associated with early dental implant failures: A retrospective analysis

Objectives

To analyze the effect of COVID-19 on early implant failures and identify potential risk factors for early implant failure, concerning patient- and implant-related factors.

Materials and Methods

This retrospective study is based on 1228 patients who received 4841 implants between March 11, 2020, and April 01, 2022, at Erciyes University Faculty of Dentistry. COVID-19, age and gender of patients, smoking, diabetes, irradiation, chemotherapy, osteoporosis, the implant system, location, and characteristics of implants were recorded. At the implant level, univariate and multivariate generalized estimating equation (GEE) logistic regression was used to examine the effect of explanatory variables on early implant failure.

Results

The early implant failure rate was 3.1% at the implant level and 10.4% at the patient level. Smokers showed a significantly higher incidence of early implant failures compared to nonsmokers. (odds ratio (OR; 95% CI): 2.140 (1.438–3.184); p < 0.001). Short implants (≤8 mm) had a higher risk of early implant failure than long implants (≥12 mm) (OR (95% CI): 2.089 (1.290–3.382); p = 0.003).

Conclusions

COVID-19 had no significant effect on early implant failure. Smoking and short implants were associated with a higher risk for early implant failures.     

Factors associated with dental implant survival: a 4-year retrospective analysis

Background: Dental implants are a predictable treatment option for replacing missing teeth and have strong survival and success outcomes. However, previous research showed a wide array of potential risk factors that may have contributed to dental implant failures. The objectives of this study are to study if implant survival rates were affected by known risk factors and risk indicators that may have contributed to implant failures. The secondary outcome measures were whether the level of expertise of the periodontal residents affected success rates and how the rate of implant success at the Harvard School of Dental Medicine (HSDM) compared to published standards. Methods: A retrospective chart review of patients at the HSDM who had one of two types of rough‐surface implants (group A or B) placed by periodontology residents from 2003 to 2006 was performed. Demographic, health, and implant data were collected and analyzed by multimodel analyses to determine failure rates and any factors that may have increased the likelihood of an implant failure. Results: The study cohort included 341 dental implants. The odds ratio for an implant failure was most clearly elevated for diabetes (2.59 implant surface group B (7.84), and male groups (4.01). There was no significant difference regarding the resident experience. The success rate for HSDM periodontology residents was 96.48% during the 4‐year study period. Conclusions: This study demonstrates that implant success rates at HSDM fell within accepted published standards, confirmed previously identified risk factors for a failure, and potentially suggested that other acknowledged risk factors could be controlled for. Furthermore, the level of experience of the periodontology resident did not have an impact on survival outcomes.     

不同颈部设计种植体在骨愈合期边缘骨变化的临床分析

目的探讨口腔种植体在骨愈合过程中,种植体光滑颈部和粗糙颈部设计对边缘骨丧失的影响。 方法2008年8月至2012年3月,因第一磨牙缺失就诊于中山大学附属口腔医院种植科,接受种植义齿修复患者137例,共151颗种植体纳入研究,通过测量根尖片中种植体周围边缘骨的高度,比较光滑颈部种植体（Replace Select^TM Tapered）和粗糙颈部种植体（XiVE^TM S）在不同颌位、直径、周期中种植体周围边缘骨的各期累计丧失量和期内丧失量的差异,结果采用SPSS 19.0软件进行统计分析。 结果在愈合期,粗糙颈部种植体边缘骨丧失量[（0.17 ± 0.01）mm]比光滑颈部种植体[（0.80 ± 0.05）mm]少,差异有统计学意义（F= 94.267,P<0.001）;在二期手术至永久修复期,粗糙颈部种植体边缘骨丧失量[（0.59 ± 0.02）mm]比光滑颈部种植体[（0.34 ± 0.01）mm]多,差异有统计学意义（F= 23.651,P<0.001）。边缘骨丧失的各期累计均值,在愈合期与期内丧失量相同,在植入至永久修复期光滑组[（1.14 ± 1.19）mm]少于粗糙组[（0.75 ± 1.12）mm],差异有统计学意义（F= 41.368,P<0.001）,不同颌位或不同直径种植体边缘骨丧失的各期累计值均值及各期期内均值差异无统计学意义（P>0.05）。 结论在愈合期,与光滑颈部相比,粗糙颈部有利于减少愈合期种植体周围边缘骨丧失量;在二期手术至永久修复期,粗糙颈部和光滑颈部种植体边缘骨高度都出现明显降低,但粗糙颈部比光滑颈部种植体边缘骨丧失更多;不同直径和不同颌位种植体对边缘骨丧失无明显影响。     

Efficacy of two antibiotic regimens in the reduction of early dental implant failure: a pilot study

The purpose of this study was to compare the efficacy of two antibiotic regimens in reducing early dental implant failure. A preoperative single-dose regimen and a 3-day antibiotic course were compared. Eighty subjects needing dental implant placement were randomly allocated to one of the two antibiotic prophylaxis regimen groups. In the first group, dental implants were placed after the administration of a single preoperative dose of antibiotic (1 g of amoxicillin); no postoperative antibiotics were given. In the second group, dental implants were inserted in patients who received the same preoperative dose of antibiotic as the first group, but the antibiotic was then continued postoperatively for 3 days. Patients returned for postoperative evaluation at 3 days, 7 days, and 12 weeks. The surgical sites were assessed for pain, swelling, wound dehiscence, and pus formation. No statistically significant difference was observed between the two groups, probably because of the limited number of patients. Although minor complications were seen in a few patients, all implants were successfully osseointegrated. Until a study with a larger population rules definitively on the role of antibiotics in implant surgery, a single dose of antibiotic before implant placement may be sufficient.     

Prophylactic antibiotic regimen and dental implant failure: a meta‐analysis

The aim of this meta‐analysis was to investigate whether there are any positive effects of prophylactic antibiotic regimen on implant failure rates and post‐operative infection when performing dental implant treatment in healthy individuals. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomised or not. The search strategy resulted in 14 publications. The I² statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used with a fixed‐ or random‐effects model, depending on the heterogeneity. The estimates of relative effect were expressed in risk ratio (RR) with 95% confidence interval. Six studies were judged to be at high risk of bias, whereas one study was considered at moderate risk, and six studies were considered at low risk of bias. The test for overall effect showed that the difference between the procedures (use versus non‐use of antibiotics) significantly affected the implant failure rates (P = 0·0002), with a RR of 0·55 (95% CI 0·41–0·75). The number needed to treat (NNT) to prevent one patient having an implant failure was 50 (95% CI 33–100). There were no apparent significant effects of prophylactic antibiotics on the occurrence of post‐operative infections in healthy patients receiving implants (P = 0·520). A sensitivity analysis did not reveal difference when studies judged as having high risk of bias were not considered. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.     

5-year clinical experience with BTI dental implants: risk factors for implant failure

Objectives: The aims of this study were to identify with appropriate statistical tests the risk factors associated with implant failure and to evaluate the long-term survival of dental implants using implant loss as an outcome variable and performing an implant-, surgery- and patient-based analysis of failures.
Material and Methods: A retrospective cohort study design was used. One thousand sixty patients received 5787 BTI^® implants during the years of 2001–2005 in Vitoria, Spain. The potential influence of demographic items, clinical items, surgery-dependent items and prosthetic variables on implant survival was studied. Implant survival was analysed using a life-table analysis. Cox proportional hazards regression was used to identify risk factors related to implant failure.
Results: Smoking habits, implant position, implant staging (two-stage implants) and the implementation of special techniques were statistically correlated with lower implant survival rates. Two risk factors associated with implant failure were detected in this study: implant staging (two-stage implants) and the use of special techniques. Additionally, the overall survival rates of BTI^® implants were 99.2%, 96.4% and 96% for the implant-, surgery- and patient-based analysis, respectively. Totally, 28 out from 5787 implants (0.48%) were lost during the observation period. Most of the patients with implant failure (69.6%) presented chronic or aggressive periodontitis.
Conclusions: Implant staging and the use of special techniques are risk factors for implant failure.     

Postoperative infections after dental implant placement: Variables associated with increased risk of failure

1 Background

Wound infections after dental implant placement are a rare finding that might lead to early implant failure. However, the available information on this topic is scarce.

2 Methods

This retrospective cohort study was conducted to determine factors that may increase the failure rate of dental implants that presented a postoperative infection during the osseointegration period. Postoperative infections were defined as the presence of pus or fistula in the surgical area, with pain or tenderness, swelling, redness, and heat or fever, before prosthetic loading. A bivariate and multivariate analysis of the data using Cox proportional‐hazards regression was performed to detect prognostic factors for implant failure in patients that suffer infections.

3 Results

The patient‐based prevalence of postoperative infections after implant placement was 2.80% (95% confidence interval (95%CI): 2.04% to 3.83%). Thirty‐three out of 37 (89.19%) patients with infections had to be surgically retreated because of antibiotic failure and 65% of the infected implants were removed. The bivariate analysis showed a significant association between implant failure and the collar surface (HR: 3.12; 95% CI: 1.16 to 8.41; P = 0.014). Cox proportional‐hazards regression indicated that rough‐surfaced collars increased 2.35 times the likelihood of failure (95% CI: 0.87 to 6.37; P = 0.071).

4 Conclusions

The survival of implants placed in the maxilla, with smooth collar, and late‐onset of infection was higher than those placed in the mandible, with a rough collar and early onset of infection. In general, signs of infection after dental implant placement compromises the survival rate of the affected fixtures.