Implant location and radiotherapy are the only factors linked to 2-year implant failure

Titanium mesh and pedicled buccal fat pad for the reconstruction of maxillary defect: case report

Background

Pedicled buccal fat pad (PBFP) has been used for the reconstruction of small-sized maxillary defects but cannot be used without hard tissue support on the defect larger than 4 cm × 4 cm × 3 cm.

Case presentation

A 64-year-old man had a history of squamous cell carcinoma of the left maxilla. After removal of the posterior maxilla, a complex bone defect (size, 5 cm × 4 cm × 3 cm) was immediately reconstructed using PBFP combined with a titanium mesh. A pinpoint fistula was found in the left palatal region 1 month after the surgery and was treated with a palatal sliding flap. There were no further complications during the follow-up.

Conclusion

The present technique demonstrated that PBFP combined with a titanium mesh could be used for the reconstruction of complex maxillary defect (size, 5 cm × 4 cm × 3 cm) without additional bone graft.

Descriptive retrospective study analyzing relevant factors related to dental implant failure

Background

The objective of this retrospective descriptive study was to analyze the characteristics of incident reports provided by dentists while using a specific brand of dental implants.

Material and Methods

The study was carried out in collaboration with Oxtein Iberia S.L.®, with the company providing access to the incident database in order to evaluate the characteristics of incidents from January 2014 to December 2017 (a total of 917 over four years). The data sheet recorded different variables during each of the stages of implant treatment, from initial implant placement to subsequent prosthetic rehabilitation. These variables included age, sex, systemic pathologies, smoking habits, bone quality, implant type, prosthesis type, and type of load applied, among others. SPSS Statistics was used to perform statistical analysis of the qualitative variables (univariate logistic regressions, χ2 test, Haberman's adjusted standardized residuals).

Results

The total study sample consisted of 44,415 implants shipped from Oxtein® warehouses on the dates indicated, of which 917 implants (2.1%) were flagged due to reports of lack of primary stability, failed osseointegration, or implant failure within one year of placement. When analyzing incident reports, it was observed that 61.6% of incidents occurred in male patients, compared to 38.4% in female patients. The average age of patients in the reported cases was 56.12 ± 12.15 years. A statistically significant correlation was discovered between incidents of implant failure and tobacco use, diabetes, heart disease, poor oral hygiene, previous infection, poor bone quality, and bruxism (p < 0.05). A (statistically significant) higher rate of incidents was also observed in tapered, internal connection, Grade IV titanium, narrow, and short implants.

Conclusions

Analysis of these implants reveals a higher rate of complication in short, tapered, internal connection and narrow-diameter implants. These data can help and encourage clinicians to use the utmost surgical precautions when placing these implants.

Key words:Pharmacovigilance, Dental implant, Dental implant failure.

A retrospective study of 30,959 implants: Risk factors associated with early and late implant loss

AIM

This retrospective study assessed the risk factors associated with early and late implant loss at the patient- and implant-based analysis.

MATERIALS AND METHODS

A total of 18,199 patients received 30,959 dental implants during the years 2011-2015. Age, gender, jaw, location, implant brands, implant length and diameter, bone augmentation procedures, and the number of implants placed per patient were recorded. A multivariate generalized estimating equation (GEE) logistic regression was used to identify risk factors related to both early and late implant loss.

RESULTS

The cumulative survival rates were 98.0% for patients and 98.7% for implants after 1-6 years observation time. A total of 183 patients with 194 implants were lost before or at the abutment connection, and 193 patients with 209 implants were lost after occlusal loading of the implant fixture. The multivariable GEE logistic regression showed that males, patients aged ≥41 years, and mandibular anterior location were risk factors for early implant loss. In the case of late implant loss, males, patients aged ≥41 years, bone augmentation and short implants were correlated with a significantly increased failure rate.

CONCLUSIONS

General factors such as male sex, elderly patients, mandibular anterior location, bone augmentation and short implants were associated with implant loss.

Risk factors for implant failure: a retrospective study in an educational institution using GEE analyses

This study aimed to evaluate dental implant outcomes and to identify risk factors associated with implant failure over 12 years via dental records of patients attending an educational institution. Dental records of 202 patients receiving 774 dental implants from 2002 to 2014 were analyzed by adopting a more reliable statistical method to evaluate risk factors with patients as the unit [generalized estimating equation (GEE)]. Information regarding patient age at implantation, sex, use of tobacco, and history of systemic diseases was collected. Information about implant location in the arch region and implant length, diameter, and placement in a grafted area was evaluated after 2 years under load. Systemic and local risk factors for early and late implant failure were studied. A total of 18 patients experienced 25 implant failures, resulting in an overall survival rate of 96.8% (2.84% and 0.38% early and late implant failures, respectively). The patient-based survival rate was 91.8%. GEE univariate and multivariate analyses revealed that a significant risk factor for implant failure was the maxillary implant (p = 0.006 and p = 0.014, respectively). Bone grafting appeared to be a risk factor for implant failure (p = 0.054). According to GEE analyses, maxillary implants had significantly worse outcomes in this population and were considered to be a risk factor for implant failure. Our results suggested that implants placed in a bone augmentation area had a tendency to fail.

General Diseases Influence on Peri-Implantitis Development: a Systematic Review

OBJECTIVES

To systematically review the influence of systemic diseases or medications used in their treatment on the dental implant therapy success.

MATERIAL AND METHODS

The search strategy was implemented on the National Library of Medicine database (MEDLINE) (Ovid) and EMBASE electronic databases between January 2006 and January 2016. Human studies with available English articles analysing the relationship between dental implant therapy success and systemic diseases, such as diabetes mellitus, AIDS/HIV, rheumatoid arthritis, osteoporosis, Crohn's disease, cardiovascular diseases, scleroderma, Sjögren's syndrome, lichen planus, ectodermal dysplasia, post-transplantation status, were included in present review according to the PRISMA guidelines. The review protocol was registered on PROSPERO system with the code CRD42016033662.

RESULTS

Present review included forty one retrospective and prospective follow-up studies, case-control studies, case report series and cohort studies. Despite some limitations this study reveals positive results of implantation in most systemic conditions that should be interpreted with caution. Influence of cardiovascular diseases on the dental implantation success should be explored deeply, because of controversial results and likelihood of comorbidity expressed by a history of cardiovascular diseases and periodontitis. There is only a weak relationship with bone density in osteoporosis and implant failure. All the other diseases did not show significant effect on implantation success.

CONCLUSIONS

Recent studies with low strength of evidence and controversy show that systemic diseases may have potential effect on the success of implantation, but further detailed studies are needed to provide these findings.

A randomized, 12-month controlled trial to evaluate non-inferiority of early compared to conventional loading of modSLA implants in single tooth gaps

Background

The aim of the study was to evaluate whether early loading of implants with a chemically modified sandblasted, large-grit, acid-etched (SLA) (SLActive®) surface was non-inferior to conventional loading in terms of change in crestal bone level.

Methods

This was a randomized, controlled, multicenter study. Patients requiring single-tooth rehabilitation in the posterior maxilla or mandible received implants and were randomized to receive a provisional restoration in occlusal load after 25 ± 3 days (early loading) or after 13 ± 1 weeks (conventional loading). The primary endpoint was change in crestal bone level between implant placement (baseline) and 6 months. Secondary endpoints included change in crestal bone level between baseline and 12 months, implant survival and success rates, and patient satisfaction.

Results

Of the 84 patients enrolled, 78 received implants and were randomized onto the early loading (41 patients) and conventional loading (37 patients) groups. The mean change in crestal bone level between baseline and 6 months was 0.56 ± 0.58 and 0.51 ± 0.62 mm for early and conventional loading, respectively; at 12 months, the mean change was 0.76 ± 0.60 and 0.73 ± 0.77 mm, respectively. Implant survival and success at 12 months were 100 % for both groups. Patient satisfaction was similar between the groups, except that more patients in the early loading group were satisfied or highly satisfied with the time taken for fitting.

Conclusion

The study demonstrated that early implant loading was non-inferior to conventional implant loading in terms of crestal bone level change in a Japanese patient population in short follow-up period and single tooth gaps in molar regions.