Osseointegrated dental implants in private practice: a long-term case series study

BACKGROUND: Osseointegrated dental implants have become a routinely recommended procedure in the clinical practice of dentistry and periodontics. Due to their predictability, they have changed the way many cases are treatment planned. The purpose of this paper is to report the results of a prospective study of factors affecting the successes and failures of a large group of dental implants and compare them to published literature. METHODS: A total of 1,003 consecutively placed pure titanium dental implants placed from August 1987 to January 2002 and followed to October 2003 are reported. All implants were placed in one private practice by the same surgeon. RESULTS: Success rates statistically were influenced only by the age of the implant, although when the raw data are examined, some trends are seen. Success was unaffected by patient age, gender, surface roughness of implant, site of placement, smoking, bone type, arch, screw versus press-fit, diameter, length, manufacturer, reason for tooth loss, site bony augmentation and timing, placement timing, one-versus two-stage placement, or torque testing of implants; 75% of failures occurred before restoration. CONCLUSIONS: Osseointegrated dental implants are a highly predictable procedure with proper case selection. Failure rates vary for a number of factors reviewed, although only the age of the implant was statistically important in predicting failure. Male smokers, maxillary first molars, and type 4 bone had increased failure rates. Threaded, surface-roughened implants had the highest success rates.