Failure Rate Of Dental Implants Research Articles

Effect of Antiresorptive Drugs on Osseointegrated Dental Implants: A Systematic Review.

Background: This systematic review aimed to evaluate the impact of antiresorptive drug therapy on osseointegrated dental implants and the association with medication-related osteonecrosis of the jaw (MRONJ). Methods: A systematic search, including a computer search of several databases with specific keywords, a reference search, and a manual search of four key maxillofacial journals were performed. Relevant articles were then evaluated and those that fulfilled the five predetermined criteria were chosen to enter the final review. A total of 445 implants in 135 subjects were included in the eight studies analyzed in the final review. Results: The failure rate of dental implants after antiresorptive medication in the included studies was 23%, with 83% of failures attributed to MRONJ. The average time from antiresorptive drug initiation to MRONJ development was approximately 34 months, ranging from 3 months to 16 years. The majority of MRONJ cases were classified as stage 2, and all sites showed either complete healing or substantial mucosal coverage after treatment. Conclusions: This review highlights the significant impact of antiresorptive drugs on osseo- integrated implants, with MRONJ identified as a leading cause of implant failure. The potential role of peri-implantitis as a trigger for MRONJ is emphasized. Regular monitoring and maintaining good periodontal health, especially within the first three years of antiresorptive drug therapy initiation, are crucial for implant success. Physicians and dentists should provide comprehensive information to patients prescribed with antiresorptive drugs, emphasizing the need for an awareness of the risks of MRONJ in the context of osseointegrated implants. A longer term of follow-up is recommended to identify and manage MRONJ around dental implants in an early manner.

Hypertension and Dental Implants: A Systematic Review and Meta-Analysis.

The aim of the present systematic review was to investigate the influence of hypertension on the dental implant failure rate. An electronic search was undertaken in four databases, plus a manual search of journals. The I2 statistic was used to check heterogeneity and the inverse-variance method was used for the meta-analysis. The estimate of relative effect for dichotomous outcome was expressed as an odds ratio (OR). The review included 24 publications. There were 4874 implants (257 failures) placed in hypertensive patients and 16,192 implants (809 failures) placed in normotensive patients. A pairwise meta-analysis showed that implants in hypertensive patients did not have a higher risk of failure than implants placed in normotensive patients (OR 1.100, p = 0.671). The log OR of implant failure between hypertensive and normotensive patients did not significantly change with the follow-up time (p = 0.824). This review suggests that implants in hypertensive patients do not present higher odds of failure in comparison to normotensive patients. However, further research on this topic, with the use of more rigorous criteria to diagnose patients as being hypertensive, as well as clearer information about the pharmacological management of the condition in the patients, is recommended.

Evaluation of Failure Rate for Cortical Dental Implants Placed in the Mandibular Anterior Region: A Systematic Review

Introduction: To enhance the success of dental implants, it is crucial to understand the factors contributing to implant failure. Practitioners should carefully evaluate the relevance and impact of critical risk factors associated with the mandibular anterior region to gauge the potential for implant failure. Aim: To assess the rates of implant failure for implants placed in the mandibular anterior region. Materials and Methods: For this systematic review, the eligibility criteria for present study included randomised and non randomised clinical trials, prospective cohort studies, and retrospective studies published in the English language between 2000 and 2022. These studies specifically documented dental implant failure rates in the anterior mandible, excluding reviews, in-vitro, cadaveric, and animal studies, as well as case series studies. The participants considered were systemically and mentally healthy individuals aged 18-90 years who had undergone oral restoration using dental implants in the anterior mandibular area. Exclusion criteria involved patients who did not undergo oral restoration with dental implants in the anterior mandibular region, those with systemic diseases affecting implant success, serious cardiac diseases, deficient homeostasis, blood dyscrasias, and psychological diseases. The intervention focused on patients rehabilitated with cortical dental implants in the mandibular anterior region, without a specific comparator or control. Based on the mentioned criteria, nine studies were included. The main outcome of interest was the dental implant failure rate. Results: The review's included studies indicated the placement of 3,718 implants in the mandibular anterior region, with 86 failures, resulting in a 2.31% failure rate, suggesting an approximate 3% failure rate for implants in this area. Conclusion: Given the multifactorial nature of implant failure, the available literature does not support the designation of the mandibular anterior region as a specific risk factor for such failures.

Bisphosphonates and Dental Implants: A Systematic Review and Meta-Analysis.

The purpose of the present systematic review was to investigate the influence of bisphosphonates (BPs) on the dental implant failure rate and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, besides a meta-regression in order to verify how the log odds ratio (OR) was associated with follow-up time. The five- and ten-year estimated implant survivals were calculated. The review included 33 publications. Altogether, there were 1727 and 21,986 implants placed in patients taking and not taking BPs, respectively. A pairwise meta-analysis (26 studies) showed that implants in BP patients had a higher failure risk in comparison to non-BP patients (OR 1.653, p = 0.047). There was an estimated decrease of 0.004 in log OR for every additional month of follow-up, although it was not significant (p = 0.259). The global estimated implant survival in patients taking BPs after 5 and 10 years was 94.2% (95% CI, 94.0-94.4) and 90.1% (95% CI, 89.8-90.3), respectively. It was not possible to make any reliable analysis concerning MBL, as only two studies reported MBL results separated by groups. There is a 65.3% higher risk of implant failure in patients taking BPs in comparison to patients not taking this class of drugs.

Retrospective Analysis of Dental Implant Failure Rates in Patients with Compromised Health.

The goal of the current research was to compare the failure rate of dental implants in medically compromised patients to healthy individuals. In this seven years retrospective study, 50 patients from Group A who were medically compromised had 63 implants, while 50 patients from Group B who were healthy had 67 implants. Over 1 mm of bone loss around the implant in the first year and over 0.2 mm of bone loss per year after that were considered failure rates. Two (2.9%) of the dental implants in Group B and 18 (28.6%) in Group A, both failed. The average bone loss around the implant in Group A during the first year was 1.21 mm, compared to 0.3 mm in Group B. Uncontrolled diabetes mellitus group had greater implant failure.

Dental implant failure rates with low insertion torque with a nonsubmerged surgical approach: A retrospective clinical study.

It is currently unclear if a low insertion torque (IT) should prompt a clinician to submerge the dental implant at time of placement. This study aimed to analyze implant failure rates and marginal bone loss (MBL) as a function of IT and surgical approach. A total of 197 patients who had received 295 Mozo Grau (MG) implants were included in this study. The healing of submerged or nonsubmerged implants was evaluated in regular IT (≥20-25 Ncm) or low IT (<20-25 Ncm) cases. Implant failure and MBL were evaluated before prosthesis placement and at 6 and 12 months after functional loading with generalized estimating equations. The overall 12-month implant failure rate was 4.8% (95% confidence interval [CI]: 2.7%-8.2%). When successful at 12 months, dental implants placed with low IT and nonsubmerging had the same MBL as implants dental implants placed with other approaches (mean difference=-0.02 mm; 95% CI -0.05 to 0.02). Low IT combined with nonsubmerging of the dental implant was associated with a 30-fold increased odds for dental implant failure (95% CI: 3.8-236.6). low IT and nonsubmerged healing was associated with a high failure rate.

Should the Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on Implant Survival.

Optimal glycemic control is crucial to dental implant long-term functional and esthetic success. Despite HbA1c levels of 7% or lower used is as an indicator for good glycemic control, however, this level may not be attainable for all diabetic patients. Most dentists do not consider patients with poor glycemic control candidates for implant therapy due to higher implant failure, infection or other complications. This review challenges the concept of one size fits all and aims to critically appraise the evidence for the success or failure rate of dental implants and peri-implant health outcomes in patients with less than optimal glycemic control. Evidence suggests that estimating glycemic control from HbA1c measurement alone is misleading. Moreover, elevated preoperative HbA1c was not associated with increased mortality and morbidity after major surgical procedures. Literature for the survival or success of implants in diabetic patients is inconsistent due to a lack of standardized reporting of clinical data collection and outcomes. While a number of studies report that implant treatment in patients with well controlled diabetes has a similar success rate to healthy individuals, other studies suggest that the quality of glycemic control in diabetic patients does not make a difference in the implant failure rate or marginal bone loss. This discrepancy could indicate that risk factors other than hyperglycemia may contribute to the survival of implants in diabetic patients. In the era of personalized medicine, the clinician should utilize individualized information and analyze all risk factors to provide the patient with evidence-based treatment options.

Diabetes Mellitus and Dental Implants: A Systematic Review and Meta-Analysis.

The present review aimed to evaluate the impact of diabetes mellitus on dental implant failure rates and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed as well as meta-regressions in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 89 publications. Altogether, there were 5510 and 62,780 implants placed in diabetic and non-diabetic patients, respectively. Pairwise meta-analysis showed that implants in diabetic patients had a higher failure risk in comparison to non-diabetic patients (OR 1.777, p < 0.001). Implant failures were more likely to occur in type 1 diabetes patients than in type 2 (OR 4.477, p = 0.032). The difference in implant failure between the groups was statistically significant in the maxilla but not in the mandible. The MBL mean difference (MD) between the groups was 0.776 mm (p = 0.027), with an estimated increase of 0.032 mm in the MBL MD between groups for every additional month of follow-up (p < 0.001). There was an estimated decrease of 0.007 in OR for every additional month of follow-up (p = 0.048). In conclusion, implants in diabetic patients showed a 77.7% higher risk of failure than in non-diabetic patients.

Dental implant failure rates in patients with self-reported allergy to penicillin.

In a number of previous studies, patients with reported penicillin allergies have been documented to experience higher rates of dental implant failure than those who had not reported this allergy. The authors of this study aimed to determine whether an increased risk of implant failure is associated with patient-reported penicillin allergy and which antibiotic was administered. A retrospective study was conducted through chart review of patients who received dental implants at the New York University College of Dentistry. Participants were eligible if they received one or more dental implants at the College and provided at least 1 year of follow-up data. The overall implant failure rate was 12.9%. The failure rate in patients who reported no allergy to penicillin and took amoxicillin was 8.4%, while the failure rate in the allergy-reporting group was 17.1% (adjusted OR=2.22, 95% CI=1.44-3.44). The failure rate in allergy-reporting patients who took Clindamycin was also higher than in those who took amoxicillin (19.9%; adjusted OR=2.9, 95% CI=1.77-4.47) or any antibiotic other than amoxicillin (20.9%; adjusted OR=2.77, 95% CI= 1.77-4.32). Significant findings included a lower implant failure rate in patients taking amoxicillin than in patients taking other antibiotics. There was a significant increase in early implant failure in allergy reporting patients.

Smoking and Dental Implants: A Systematic Review and Meta-Analysis.

Background and Objectives: Tobacco is today the single most preventable cause of death, being associated with countless diseases, including cancer and neurological, cardiovascular, and respiratory diseases. Smoking also brings negative consequences to oral health, potentially impairing treatment with dental implants. The present review aimed to evaluate the influence of smoking on dental implant failure rates and marginal bone loss (MBL). Materials and Methods: Electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, in addition to meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. Results: The review included 292 publications. Altogether, there were 35,511 and 114,597 implants placed in smokers and in non-smokers, respectively. Pairwise meta-analysis showed that implants in smokers had a higher failure risk in comparison with non-smokers (OR 2.402, p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 2.910, p < 0.001), as well as in the mandible (OR 2.866, p < 0.001). The MBL mean difference (MD) between the groups was 0.580 mm (p < 0.001). There was an estimated decrease of 0.001 in OR (p = 0.566) and increase of 0.004 mm (p = 0.279) in the MBL MD between groups for every additional month of follow-up, although without statistical significance. Therefore, there was no clear influence of the follow-up on the effect size (OR) and on MBL MD between groups. Conclusions: Implants placed in smokers present a 140.2% higher risk of failure than implants placed in non-smokers.

Dental Implants Inserted in Fresh Extraction Sockets versus Healed Sites: A Systematic Review and Meta-Analysis.

The present review aimed to evaluate the difference of dental implant failure rates and marginal bone loss (MBL) between implants inserted in fresh extraction sockets or healed sites. Electronic search was undertaken in three databases, plus manual search of journals, including studies randomized or not. Meta-analyses were performed besides meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 163 publications. Altogether, there were 17,278 and 38,738 implants placed in fresh extraction sockets and healed sites, respectively. Pairwise meta-analyses showed that implants in sockets had a higher failure risk in comparison to healed sites: OR 1.349, all studies included; OR 2.070, only prospective non-RCTs; OR 2.487, only RCTs (all p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 1.616, p = 0.029), but not in the mandible (OR 2.192, p = 0.075). The MBL mean difference (MD) between the groups was −0.053 mm (p = 0.089). There was an estimated decrease of 0.003 in OR (p = 0.284) and an increase of 0.006 mm (p = 0.036) in the MBL MD between groups for every additional month of follow-up. In conclusion, implants placed in fresh extraction sockets present higher risk of failure than implants placed in healed sites.

Failure Rate, Marginal Bone Loss, and Pink Esthetic with Socket-Shield Technique for Immediate Dental Implant Placement in the Esthetic Zone. A Systematic Review and Meta-Analysis.

Simple SummaryThe socket-shield technique has been proposed for preserving the bone ridge and surrounding soft tissues with immediate implantation in the extraction socket, maintaining the buccal wall fragment of the dental root. However, the socket-shield technique has not been compared with the conventional technique for immediate dental implant placement in the esthetic zone regarding the failure rate, marginal bone loss, and pink esthetic. Therefore, it is necessary to develop a systematic review and meta-analysis that provides evidence associated with the prognosis when using the socket-shield technique compared to the conventional technique.Aim: To compare the failure rate, marginal bone loss, and pink esthetic for the socket-shield technique and the conventional technique for immediate dental implant placement in the esthetic zone. Material and methods: A systematic literature review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the failure rate, marginal bone loss, and pink esthetic with the socket-shield technique for immediate dental implant placement in the esthetic zone was performed. A total of 4 databases were consulted in the literature search: PubMed-MEDLINE, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, 16 articles were selected for the qualitative and quantitative analysis. Results: Four randomized controlled trials, five prospective clinical studies, four retrospective studies, and three case series were included in the meta-analysis. The dental implant failure rate for the socket-shield technique for immediate dental implant placement was 1.37% (95% CI, 0.21–2.54%); however, no statistically significant differences between the conventional and socket-shield technique were found. The estimated mean difference in the marginal bone loss for the socket-shield technique was −0.5 mm (95% CI, −0.82 to −0.18) and statistically significant (p < 0.01), with a high heterogeneity (I2 = 99%). The mean pink esthetic score was 12.27 (Q test = 4.47; p-value = 0.61; I2 = 0%). The difference in pink esthetic between the conventional (n = 55) and socket-shield techniques (n = 55) for immediate dental implant placement was 1.15 (95% CI, 0.73–1.58; Q test = 8.88; p value = 0.11; I2 = 44%). The follow-up time was found to be significant (beta coefficient = 0.023; R2 = 85.6%; QM = 3.82; p = 0.049) for the PES for the socket-shield technique. Conclusions: Within the limitations of this systematic review with meta-analysis, the dental implant failure rate did not differ between the socket-shield technique and conventional technique for immediate implant placement in the esthetic zone. However, a lower marginal bone loss and higher pink esthetic scores were found for the socket-shield technique compared to the conventional technique.

THE EFFECT OF LOCAL AND SYSTEMIC FACTORS ON DENTAL IMPLANT FAILURE - ANALYSIS OF 670 PATIENTS WITH 1260 IMPLANTS.

SUMMARYThe etiopathogenesis of dental implant failure is multifactorial and may include numerous local and systemic factors, however, studies including both local and systemic factors are still lacking. Therefore, the aim of this study was to evaluate whether periodontal disease, oral hygiene index, i.e. bleeding on probing (BOP), full mouth plaque index (FMPI), smoking, systemic diseases, as well as implant characteristics (length and diameter) affect failure of implant-prosthodontic therapy. Data on 670 patients were retrieved in whom 1260 dental implants had been placed and followed-up for at least five to ten years. Categorical data were analyzed by the χ2-test, whereas Mann-Whitney test was used for continuous variables (age, BOP and FMPI). The values of p<0.05 were considered significant. The effect of local and systemic factors on the success of implant-prosthodontic therapy was assessed by multiple logistic regression analysis. Forty-five (6.7%) patients had systemic diseases, of which diabetes mellitus was most common, followed by atherosclerosis, diabetes and atherosclerosis, diabetes mellitus type 1, lymphoma, and hepatitis C. One-third (33.4%) of the patients were smokers. Periodontal disease was present in 170 patients, while 500 patients were without periodontal disease. Nine implants were lost during the period of five years. There were no differences regarding the type of implant or type of connection to the prosthetic suprastructure. However, most of these patients had a periodontal disease. There were no significant differences in dental implant failure rates between smokers and non-smokers or between patients with and without systemic diseases. Furthermore, the results of this study showed that implant type (straight vs. tapered) and type of connection with prosthodontic appliance (cemented or screw retained) did not affect BOP and FMPI. In smokers, significant improvement of BOP and FMPI was noticed. Initially, smokers had a significantly worse BOP (0.0037) when compared to non-smokers; however, there were no differences regarding FMPI (p=0.4218) between the two groups. In patients with periodontal disease, improvement of BOP and FMPI was seen at 5-year follow-up and no significant differences were found when compared to patients without periodontal disease. There were no significant differences in BOP and FMPI between patients with and without diabetes at 5-year follow-up. Atherosclerosis had a significant negative effect on BOP, but not on FMPI at 5-year follow-up. It is concluded that periodontal disease had a significant impact on the implant-prosthodontic therapy.

Dental Implant Failure Rate and Marginal Bone Loss in Transplanted Patients: A Systematic Review and Meta-Analysis

This systematic review investigates the failure rate and marginal bone loss (MBL) of dental implants placed in patients undergoing solid-organ transplant (SOT) compared to healthy controls. Three databases (PubMed, Web of Sciences, and the Cochrane Library) were searched up to June 2020 (PROSPERO CRD42019124896). Case-control and cohort studies reporting data failure rate and marginal bone loss (MBL) of dental implants placed in SOT patients were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Four case-control studies fulfilled the inclusion criteria; all had low risk of bias. Meta-analyses revealed consistently lower implant failure rate than control populations at patient and implant levels. SOT patients had a significant difference of −18% (p-value &lt; 0.001) MBL compared to healthy patients. SOT status poses no serious threat to implant survival. Overall, this group of patients presented lower levels of dental implant failure rate and marginal bone loss compared to otherwise healthy patients. Further intervention trials with larger sample size and longer follow-ups are necessary to confirm these summarized results.

Dental Implants in Patients with Oral Lichen Planus: A Systematic Review.

Background and Objectives: To integrate the available published data on patients with oral lichen planus (OLP) rehabilitated with dental implants, as well as to review the recommendations for OLP patients receiving implants. Materials and Methods: An electronic search was undertaken in February 2019 using five databases. Publications reporting cases of patients with OLP and rehabilitated with implant-supported oral prosthesis were included. Results: Twenty-two publications were included (230 patients, 615 implants). The overall implant failure rate was 13.9% (85/610). In patients with oral squamous cell carcinoma (OSCC) the failure rate was 90.6% (29/32), but none of these implants lost osseointegration; instead, the implants were removed together with the tumor. One study presented a very high implant failure rate, 76.4% (42/55), in patients with “active lichen planus”, with all implants failing between 7–16 weeks after implant placement, and its conflicting and incongruent results are discussed in detail. There was a statistically significant difference between the failure rates in implants installed in different jaws (maxilla/mandible) and when implants of different surfaces were used (turned/moderately rough), but not between patients with reticular or erosive OLP types, or between male and female patients. If OSCC patients and the cases of the latter study are not considered, then the failure rate becomes very low (2.7%, 14/523). The time between implant placement and failure was 25.4 ± 32.6 months (range 1–112). The mean ± SD follow-up was 58.9 ± 26.7 months (1–180). Conclusions: When the results of the one study with a very high failure rate and of the cases that developed OSCC are not considered, the dental implant failure rate in OLP patients was 2.7% after a follow-up of approximately five years. Recommendations are given when treating OLP patients with dental implants.

Assessment of failure rate of dental implants in medically compromised patients.

Background and Aims:The present study was conducted to assess failure rate of dental implant in medically compromised patients.Methods:This study comprised of 68 medically compromised patients of both genders who underwent dental implants 5 years ago (Group I). Equal number of healthy subjects was taken as control (Group II). Amount of bone loss around the implant over 1mm of bone loss in the first year and over 0.3 mm bone loss every subsequent year were considered as failures.Results:The age group of 30-40 comprised of 25 patients in group I and 35 in group II, 40-50 years had 27 in group I and 23 in group II and 50-60 years had 16 in group I and 10 in group II. Medically compromised patients were diabetes (25) with 30 dental implants followed by osteoporosis (16) with 17 dental implants, hypothyroidism (12) with 14 dental implants, organ transplant (10) with 12 dental implants and CVD (5) with 7 dental implants. Chi- square test was applied which revealed significant difference in patients (P < 0.05). In group I, there were 18 (22.5%) and in group II, there were 4 (5.56%) dental implant failures. The difference with chi- square test found to be significant P < 0.05).Conclusion:Among medically compromised conditions, higher failure rate was found in diabetes.

Assessment of the Survival Rate of Short Dental Implants in Medically Compromised Patients

To assess the survival rate of short dental implants in medically compromised patients. This follow-up study was conducted on 342 medically compromised patients of both genders (580 dental implants). The failure rate of dental implants was assessed. There were 142 diabetes mellitus patients with 254 dental implants, 108 patients with hypertension with 190 dental implants, 26 patients with mental disabilities with 40 dental implants, 20 oral cancer patients with 36 dental implants, and 46 osteomyelitis subjects with 60 dental implants. There were 60 (10.5%) short dental implant (SDI) failures of which a maximum of 25 (22.7%) were seen with 4 mm diameter. Maximum failure was seen with osteomyelitis patients 8 (13.3%) followed by diabetes mellitus 32 (12.5%). Out of 270 dental implants in 130 control patients, implant failure was seen in 11 (4.07%). There was a significant (p < 0.05) bone loss on follow-up at 6 months, 1 year, and 2 years. Medically compromised patients are more prone to dental implant failure as compared to healthy subjects. Since medically compromised patients are prone for implant failure, careful selection of cases is necessary.

Sex hormone replacement therapy in periodontology-A systematic review.

To analyse whether sex hormone replacement therapy (HRT) improves periodontal parameters and dental implants osseointegration in humans. Electronic databases and hand searches were performed from June to August 2018 in SciELO, LILACS and PubMed/MEDLINE. Human observational and interventional studies that evaluated the following parameters were included: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), radiographic bone loss (RBL) or osseointegration. Initial search retrieved 1,282 non-duplicated articles. Fifteen studies were selected after inclusion criteria were applied. All studies were performed in postmenopausal women. Mean differences for PPD reduction ranged from 0.02 to 0.2mm in HRT-positive patients; mean CAL gain -0.18 to 0.54mm; mean RBL reduction -0.87 to 0.15mm; and mean BOP reduction 9%-30.3%. Failure rate of dental implants increased -5.5% to 11.21% when HRT was used. Very low but consistent evidence suggests a reduction in BOP and no impact on RBL in postmenopausal women receiving HRT. There are inconsistent reports that suggest that HRT in postmenopausal women: (a) improves or does not impact PPD reduction and CAL gain; and (b) does not impact or increase implant loss. In summary, there is no evidence to support HRT prescription for either men or women for periodontal/implant placement purposes.

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

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. 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. 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). 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.

Comparison of Early Implant Failure Rates Between Subjects With and Without Orthodontic Treatment Before Dental Implantation.

The present study compared early dental implant failure rates between patients with and without orthodontic treatment before dental implantation. The data of adults who had undergone dental implantation between January 2007 and December 2016 were analyzed retrospectively. A total of 124 subjects with 255 implants were divided into a treatment group (46 subjects, 85 teeth) consisting of patients who had undergone implant surgery after orthodontic treatment and a control group of patients who had not undergone preimplant orthodontic treatment. Implants that failed before permanent crown fabrication were defined as failures. No significant differences in gender or age were found between the treatment group and controls. No significant differences were found in implant failure rates in either jaw between the treatment and control groups. However, the failure rate was still higher in the treatment group (14.81%) than in the control group (3.28%) for the maxilla. Results of this study demonstrate an increased implant failure rate only in the maxilla of patients who underwent orthodontic treatment before dental implantation, especially implant surgery combined with a sinus lift procedure. Further study with a larger sample size and longer follow-up period is necessary to confirm results of the present study and identify other confounding factors.