Dense cancellous bone as evidenced by a high HU value is predictive of late implant failure: a preliminary study.

Abstract

The mechanism of late implant failure is unclear. This study examined the association between sclerosing cancellous bone images and the risk of late implant failures using multi-detector row computed tomography (CT) imaging data. We performed a case-control study. The study group consisted of consecutive patients with implant failures treated at Kyushu Dental University between 2001 and 2016. CT data for late failure of 36 implants in 16 patients were available. The study cohort consisted of 16 patients with 36 late failed implants and 28 patients with 113 successful implants. The mean survival rate was 6.9months for early implant failure, 76.6months for late failure with marginal bone resorption, inflammation symptoms, and so-called peri-implantitis, and 95.0months for late failure caused by implant fracture. The mean HU value for cases in the control group was 507 compared with 1231 for cases with late failure implants. Logistic regression was used for analysis. There were signs of high radiodensity of peri-implant cancellous bone when comparing adjusted radiodensity per 100 HU using CT data (OR 2.35; 95% CI 1.73-3.20; p<0.001). Within the limits of our study, the presence of high radiodensity and cancellous bone consolidation on imaging may be related to risk factors for late implant failure. Therefore, CT images of the host cancellous bone status for observation of visible sclerosis could be a useful diagnostic indicator for late implant failure.