Implant Failure Rate Research Articles

Survival Rates and Risk Factors of Resorbable Blast Media Surface Dental Implants: A Retrospective Cohort Study with an Average 60-Month Follow-Up.

This retrospective cohort study aimed to evaluate the survival rates and risk factors associated with Resorbable Blast Media (RBM) surface dental implants. The study involved 1,130 implants placed in 260 patients, with a follow-up ranging from a minimum of 26 months to a maximum of 120 months, for an average of 60 months. 1,130 RBM surface implants with hybrid macro-geometry were placed in 260 patients. Implant survival and failure rates were analyzed over an average 60-month follow-up. Failure rates were examined based on implant length, patient gender, and sinus lift procedures. Additional factors, including patient age, implant placement timing (immediate vs. delayed), guided bone regeneration (GBR), implant diameter, and implant location, were assessed to determine their impact on long-term implant success. The overall survival rate for the implants was 94.4%, with most failures occurring within the first 12 months postplacement. Male patients experienced significantly higher failure rates (7.36%) than female patients (4.0%). Short implants (8 mm) were particularly vulnerable to failure, with an 8.65% failure rate. Sinus augmentation procedures also presented an increased risk, with 10% failure for lateral sinus augmentation and 9.78% for crestal sinus elevation. In contrast, factors such as patient age, timing of implant placement, GBR, implant diameter, and implant location did not significantly influence failure rates. Notably, narrow-diameter implants (3.3 and 3.7 mm; n=97) in the molar region did not increase the risk of failure, with only 5 experiencing failure. Failures post-prosthetic loading were most common after about 3 years. This study confirms the long-term viability of RBM surface implants, with high survival rates when early failures are mitigated. Short implants and sinus lift procedures pose greater risks of failure, particularly in the early stages. However, simultaneous GBR and sinus procedures did not significantly impact long-term outcomes, affirming the safety and efficacy of these complex interventions.

Survival and Success of 3D-Printed Versus Milled Immediate Provisional Full-Arch Restorations: ARetrospective Analysis.

To evaluate and compare the survival rates of 3D-printed and chairside milled resin polymethylmethacrylate (PMMA) immediate temporary provisional full-arch implant restorations using prosthetic survival as the primary outcome. Records of 335 routine patients receiving 443 temporary six-implant retained maxillary or mandibular prosthetic restorations between January 2019 and January 2022 at a private clinic (Dr Sobczak Clinical Centre, Radosc, Poland) were considered for this retrospective analysis. The analysis compared prosthetic and implant failure rates between printed and milled restorations as primary and secondary outcomes, respectively. Patient-related and treatment-related characteristics between groups were compared using the Chi-square test and Mann-Whitney U-test, respectively. Group-specific cumulative prosthetic survival was qualitatively and quantitively compared using Kaplan-Meier, generalized linear mixed models and univariate cox proportional hazard analyses. Prosthetic survival was set into context to implant survival using Chi-square tests. A multivariable cox proportional hazards model with frailty was used to identify confounding factors affecting prosthetic survival. Prosthetic failure rates of milled and printed temporary restorations were 13.01% and 11.25% over the average follow-up period of 307.7 ± 115.5 days, respectively. The corresponding 180-day cumulative prosthetic survival rates were 92.4% and 93%. Hazard ratios for the prosthetic failure of milled and printed restorations did not show a statistical difference (p = 0.794). Implant failure rates in restorations that experienced prosthetic failure (17.31%) were higher compared to restorations without failures (5.63%), with a 3.2 times significantly higher odds of failure for a prosthesis experiencing implant loss (p = 0.003). Gender, presence of teeth at treatment baseline, smoking, and bone augmentation were identified as confounding factors impacting prosthetic survival. Chairside 3D-printed restorations may represent an equivalent treatment modality to established chairside milled restorations for immediate full-arch therapy. Provisional prosthetic survival may impact implant survival and treatment success.

Effects of clindamycin and amoxycillin as prophylaxis against early implant failure: double-blinded randomized clinical trial.

The objective of this randomized controlled clinical trial (RCT) was to compare the frequency of early implant failure, postoperative infection, and pain/inflammation and the degree of implant stability between healthy non-penicillin-allergic individuals receiving a single prophylactic dose of 600mg clindamycin versus 2g amoxicillin at 1h before implant surgery. A single-center double-blinded RCT study with parallel groups was undertaken. Eighty-two patients fulfilled study inclusion criteria and were randomly assigned to the amoxicillin (n = 41) or clindamycin (n = 41) group. The primary outcome variable was early implant failure. The presence of infection was evaluated immediately after surgery and on days 7, 14, 30, and 90, and postoperative pain/inflammation was assessed daily on days 1 to 7 post-surgery. Resonance frequency analysis was used to measure primary and secondary implant stability. One early implant failure was observed (1/81), in a patient from the amoxicillin group. No statistically significant between-group differences were observed in early implant failure rate, postoperative infection rate up to 90 days, pain/inflammation scores during the first week post-surgery, or primary or secondary stability values. A single dose of 600mg clindamycin before implant surgery does not increase the risk of early implant failure or infection. These findings suggest that a single dose of 600mg clindamycin at 1h before implant surgery is a safe antibiotic prophylactic approach; however, when a more prolonged antibiotic therapy is required, it appears advisable to prescribe an alternative antibiotic to avoid adverse effects.

Postoperative Complications of Intramedullary Nailing for Impending and Pathologic Fractures of the Humerus Due to Bone Metastases-A Systematic Review of the Literature.

Intramedullary nailing (IMN) is a common option for managing impending or pathologic fractures of the humerus secondary to metastatic disease. We sought to assess the (1) early complications, (2) failure rates and mechanisms, and (3) functional outcomes. A systematic review using the PubMed, Embase, and Cochrane databases was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The study was registered on PROSERO (CRD42023406905). The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for quality assessment. Studies describing postoperative outcomes of patients with impending or pathologic fractures of the humerus treated with IMN were included. Implant failure was classified into mechanical and nonmechanical causes. Functional outcomes were assessed via the Musculoskeletal Tumor Society (MSTS) score. Overall, 41 studies comprising 1431 patients were included. Early complications occurred in 5.5% of patients, with 2.8% of patients having systemic complications. The overall implant failure rate was 4.9%, and the mean MSTS score at the last follow-up was 79.9%. IMN was associated with good postoperative functional outcomes and low implant failure rates. Systemic complications were the most common type of early complication, and tumor progression was the main cause of implant failure. LEVEL OF EVIDENCE: III.

Simultaneous Implantation of Maxillary Fibroskeletal Lesions: A Case Report and Literature Review.

To investigate a clinical case of simultaneous implantation therapy for a patient with fibroskeletal disease of the jaw, and to provide a clinical basis for the treatment of such patients by clinical prosthetists. The clinical data of a patient with fibroskeletal disease of the jaw undergoing implant treatment were collected, and the clinical repair plan for this patient was discussed by reviewing the literature. The patient, a female, 49 years old, right upper posterior tooth missing for 1 year, through the maxillofacial surgery consultation, according to the imaging data, the maxillary fibroskeletal lesions were considered. The tumor was removed, bone regeneration was guided, and microimplants were implanted at the same time. Cone Beam Computed Tomography was performed at 3, 9, and 20 months postoperatively, and according to clinical evaluation, the patient did not show any signs of recurrence. At the same time, a literature search was conducted to summarize the data on simultaneous implantation therapy for fibroskeletal lesions of the jaw. The treatment plan of tumor removal → guided bone regeneration → simultaneous implantation of microimplants can effectively achieve implant repair and reduce the failure rate of implants in patients with jaw fibroskeletal lesions.

Impact of systemic diseases on oral health and facial surgery outcomes

Systemic diseases have a profound influence on oral health and maxillofacial surgical outcomes, presenting challenges that require comprehensive management. Diabetes mellitus is a prominent example, with its impact on periodontal health and healing processes being well-established. Elevated blood glucose levels in diabetic patients impair immune response, reduce collagen synthesis, and delay wound healing, increasing the risk of periodontitis and postoperative complications following surgical interventions such as dental implants. Similarly, cardiovascular diseases exacerbate the inflammatory response linked to periodontal disease, potentially worsening both oral health and systemic conditions, thus complicating the recovery process after maxillofacial surgery. These patients often face heightened risks of infections and slower healing, partly due to the frequent use of anticoagulant medications, which can interfere with surgical procedures. Immunocompromised individuals, such as those with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) or undergoing chemotherapy, also experience significant oral health challenges, including higher susceptibility to oral infections and delayed tissue repair. Reduced immune function and mucosal integrity make it difficult for these patients to recover effectively after maxillofacial surgery, increasing the risk of complications such as infection and wound dehiscence. Moreover, osteoporosis, a systemic condition characterized by reduced bone density, affects the success of dental implants and bone grafting procedures. The decreased bone quality in osteoporotic patients compromises the ability to achieve stable osseointegration, leading to higher implant failure rates and additional surgical challenges. Addressing these complex interactions between systemic health and oral conditions requires an interdisciplinary approach, integrating medical and dental care to enhance treatment outcomes. Proper management of systemic diseases, along with individualized dental and surgical protocols, is essential to improving the prognosis for patients with concurrent systemic and oral health issues.

No association between periodontitis extent, severity, and progression rate with dental implant failure

ObjectiveTo analyze the relationship between extent, severity, and rate of progression of periodontitis with the implant outcome. MethodsDental records of adult patients who had attended the dental clinics of the universities contributing data to the BigMouth network between 2011 and 2022 seeking implant therapy were evaluated. Patients' records were furthered examined for a periodontal diagnosis based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Patients were further categorized based on extent (generalized/localized), severity (stage I, II, III, IV), and rate of progression (grade A, B, C). Information including demographic characteristics, self-reported medical conditions, as well as the number of missing teeth were extracted from patients' electronic health records. ResultsRecords of 50,312 dental implants placed in 20,842 patients over a 12-year period were screened. Three hundred twenty-two records of implants were placed in patients with a recorded periodontitis diagnosis based on the 2017 periodontal classification. The mean age of the cohort was 57.53±12.95 years which consisted of 52.2 % males, 74.2 % non-Hispanic, 55.9 % white individuals, 9 % diabetics, 3.4 % tobacco users. The univariate analysis demonstrated that periodontitis extent, severity, and rate of progression were not significantly associated with the treatment outcome. The implant failure rate was estimated to be 5.6 %. ConclusionsWithin the limitations of this retrospective study that utilized records of dental implants placed in institutions in the United States contributing data to the BigMouth network, the implant failure rate was estimated to be 5.6 %. Periodontitis extent, severity, and rate of progression were not significantly associated with the implant treatment outcome.

Use of morselized bone allograft in revision hip arthroplasty for massive acetabular defect: A systematic review and meta-analysis.

Many treatment options are available for the revision of large acetabular defects. Debate continues as to which technique is most effective. This meta-analysis aimed to determine the rates of failure of acetabular bone defects Paprosky type III or American Academy of Orthopaedic types III-IV treated with morselized allograft in association with cemented cup or cementless cup or reinforcement devices. The US National Library of Medicine (PubMed/MEDLINE), EMBASE and the Cochrane Database of Systematic Reviews were queried for publications from January 1980 to 1 April 2024 utilizing keywords pertinent to total hip arthroplasty (THA), acetabular impaction bone grafting and revision THA. The main outcome measure was the 9-year implant failure rate. Thirty-nine articles were eligible for inclusion in the current study. We found 41 treatment approaches that we grouped into three different treatment options: 1 = morselized allograft and cemented cup (10 studies); 2 =morselized allograft and cementless cup (nine studies); 3 = morselized allograft and device (22 studies). The overall implant failure rate was 2.1% (95% confidence interval [CI], 1.6%-2.8%) at a mean of 9.2 years. There was no significant difference in failure rates between different treatment options (1.6% [95% CI, 0.9%-2.6%]) for morselized allograft and cemented cup; 2.1% (95% CI, 1.4%-3.2%) for morselized allograft and cementless cup; 2.5% (95% CI, 1.7%-3.7%) for morselized allograft and device) between the three different types of treatment (heterogeneity between groups p = 0.351).It was determined that the number one cause of failure was aseptic loosening (80.5%), followed by infection (13.1%) and dislocation (6.4%). THA with reinforcement devices has a higher incidence of infection (3.6 vs. 0.7%, p = 0.001) and dislocation (1.4 vs. 0.6%, p = 0.010) than THA with a cemented cup. The use of morselized allograft in hip revision of large acetabular defects has low implant failure rates, independently of the associated type of implant. Reinforcement devices increase the risk of re-revision for infection and dislocation. Level III.

Total Elbow Arthroplasty Follow Up 10 Years in Rheumatoid Arthritis, A Systematic Review/Meta-Analysis

Abstract Background Rheumatoid arthritis is the most common form of chronic inflammatory arthritis and affects about 1% of adults. It is characterized by progressive, symmetrical arthritis involving many joints, most commonly the knee, wrist and interphalangeal joints. The elbow is affected in between 20% and 65% of patients, often causing severe painful disability. In patients with severe arthritis, many forms of treatment are available to relieve pain and improve function. Total elbow arthroplasty is commonly performed for end-stage arthritis. However, Total elbow arthroplasty has inferior implant survival and higher complication rates compared with arthroplasties of other major joints. This is usually thought to be due to the high risks associated with Rheumatoid arthritis and the complex anatomy of the elbow joint. Aim of the Work The aims of this study were to report on the long term outcome of total elbow arthroplasty in patients with rheumatoid arthritis, and to identify factors that affect the outcome patients satisfaction. Patients and Methods We searched PubMed, MEDLINE, Cochrane Reviews, and Embase from between January 2005 and March 2020. The primary aim was to determine the implant failure rate, the mode of failure, and risk factors predisposing to failure. A secondary aim is to identify the overall complication rate, associated risk factors and clinical performance. A meta- regression analysis completed to identify the association between each parameter with the outcome. The initial literature search resulted in 4776 studies, with 4665 duplicates subsequently removed. The remaining 111 studies were screened using our exclusion criteria. Following application of our exclusion criteria, the full texts of 111 studies were thereafter evaluated with our inclusion criteria to screen for eligibility. Overall, 13 clinical studies including 349 elbows were included in this study Results According to the movement degree, flexion was recorded in 5 studies with 229 elbows and it was found that there was a significant difference in pre and post-operative groups (p < 0.001, I2 = 90%). Extension was recorded in 5 articles with 229 elbows. It was found that there was no significant difference in pre and post-operative groups (p = 0.12, I2 = 53%). Supination was recorded in 5 articles with 229 elbows. It was found that there was a significant difference in pre and post-operative groups (p = 0.008, I2 = 79%). Pronation was recorded in 5 papers with 209 elbows. It was found that there was a significant difference in pre and post-operative groups (p = 0.003, I2 = 83%). Conclusion Although elbow replacement is performed far less frequently than hip, knee, or shoulder replacement, its use is increasing and information for patients and clinicians on the longevity of implants and impact on quality of life is vital. Patients experienced a sustained improvement in pain and function for the 10 years following surgery.

The Effects of Smoking on Dental Implant Failure: A Current Literature Update.

Background: This systematic review assesses the current literature (2020-2024) evaluating the impact of smoking on dental implant failure rates. Methods: A non-funded Pubmed database review was conducted according to PRISMA guidelines, and the results were tabulated to extract the study design, patient characteristics, follow-up time, comparison, outcome, and strengths and weaknesses, including risk of bias. This review included 33 studies with 29,519 implants placed in over 18,301 patients. We included prospective and retrospective clinical studies, randomized and non-randomized controlled trials, cohort studies, and observational studies that examined smoking's effects on implant failure rates. Studies had to classify individuals into two groups, smokers and non-smokers, with at least ten implants. Exclusions included reviews, case reports, experimental studies, guidelines, non-English publications, studies lacking comparative data on failure rates, those excluding smokers, and studies focusing on head and neck cancer patients or specialized implants. Results: Our findings indicate a significant correlation in 25 out of 33 studies between smoking and increased implant failure rates, affecting both early and late stages of implant integration and survival as well as revealing a dose-response relationship, with higher daily cigarette consumption significantly increasing the risk of implant failure. Conclusions: This review highlights the importance of smoking cessation efforts, patient education, and tailored patient care in dental implantology. Future research should explore the effects of smoking frequency and alternative tobacco products, such as e-cigarettes, aiming to improve success rates among smokers.

Evidence-Based Critical Assessment of the Success Rate of Dental Implants in Smokers: An Umbrella Systematic Review.

The aim of this umbrella systematic review is to evaluate the success rate and osseointegration of dental implants in patients with a smoking habit. Electronic database searches of PubMed/Medline, Google Scholar, ScienceDirect, Cochrane Library, and EBSCOhost were done from 2006 until August 2024, using medical subject headings (MeSH) terms. Systematic reviews and meta-analyses (SRMAs) investigating the association between smoking and the rate of success of dental implants based on dental implant failure, marginal bone loss, survival, and peri-implant parameters were deemed eligible. The Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2) was used to assess the quality of the included SRMAs. Seventeen systematic reviews have been included. In the reviews, 10 studies included meta-analyses (MAs) that evaluated implant failure rate and marginal bone loss. According to the AMSTAR 2 checklist, one review was scored "high," seven reviews were scored "moderate," seven reviews were scored "low," and two reviews were scored "critically low" quality. The strength of evidence suggests a low level of success and high rate of failure of osseointegration of dental implants in smokers. However, the influence of smoking on the rate of dental implant failure seems to be associated with various factors such as peri-implant inflammatory markers, post-operative infections, etc. Inherently, the conclusion of this review is based on a limited number of systematic reviews.

Personalized embryo transfer guided by rsERT with hourly precision improves pregnancy outcomes in patients with a receptive window of implantation: a pilot study.

To investigate whether personalized embryo transfer (pET) predicted by a modified RNA-sequencing-based endometrial receptivity test (rsERT) model can improve intrauterine pregnancy rate (IPR) in patients with a receptive window of implantation (WOI). A retrospective pilot study was conducted in the Center for Reproductive Medicine, Central South University, from January 2018 to December 2023. A total of 524 patients with receptive WOI results from rsERT were assigned into two groups based on whether they underwent conventional embryo transfer (conventional ET) or pET. Patients in the conventional ET were matched with those in the pET group at a 1:1 ratio using propensity score matching (PSM). Before PSM, the IPR (55.73% vs. 46.19%, P = 0.032) and implantation rate (IR) (47.51% vs. 34.03%, P = 0.000) in the pET group were significantly higher than that in the conventional ET group. However, the number and types of transferred embryos differed significantly between the two groups. After adjusting for confounding factors, IPR (57.38% vs. 44.81, P = 0.016) and IR (46.81% vs. 33.10%, P = 0.001) remained significantly higher in the pET group compared to the conventional ET group. The implantation failure rate was significantly lower in the pET group compared to controls (42.62% vs. 55.19%, P = 0.016). Additionally, the multiple-pregnancy rate was significantly higher in the pET group compared to the conventional ET group (10.29% vs. 1.68%, P = 0.001). Women with receptive WOI results could benefit from the receptivity-timed pET predicted by the newly refined rsERT. These findings provide a basis for future research in precision medicine for embryo transfer.

Analysis of risk indicators for implant failure in patients with chronic periodontitis

Dental implant restoration shows an effective method for the rehabilitation of missing teeth. The failure rate of periodontal implants in patients with chronic periodontitis is associated with periodontal flora, inflammation, and long-term periodontal bone resorption caused by chronic periodontitis. However, the therapeutic effects of dental implant restoration on inflammation in patients with chronic periodontitis have not addressed. The purpose of this study is to evaluate the risk indicators for inflammation, bone loss and implant failure in patients with chronic periodontitis. A total of 284 patients with dental implant restoration were recruited and divided into periodontally healthy patients (n = 128) and chronic periodontitis patients (n = 156). Periodontal indices including probing depth (PD), sulcus bleeding index (SBI), plaque index (PLI), gingival bleeding (GIL) and bleeding on probing (BOP) were compared in two groups. Inflammatory cytokines including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1 (IL-1), matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) levels at baseline, 6 and 12 months after surgery, and the implant survival rate at 12 months after surgery, as well as the risk factors associated with failure of dental implant were also assessed. Outcomes demonstrated that patients in the chronic periodontitis group had higher values of periodontal indices than those in the periodontally healthy group. All inflammatory parameters in the chronic periodontitis group were higher than those in the periodontally healthy group and negatively associated with the chronic periodontal index (CPI) in chronic periodontitis patients. Chronic periodontitis patients had higher the prevalence of mucositis and peri-implantitis than patients with healthy periodontium. Implant diameter, length and design was associated with the risk of implant failure for chronic periodontitis patients receiving dental implant. The cumulative implant failure rate and incidence of implant fractures for chronic periodontitis patients at 12 months after surgery were 12.10% and 7.23% (p < 0.05), respectively, while were lower in the heathy periodontitis patients. Location, diameter, implant design, immediate loading and bone defect were risk indicators for bone loss for dental implant patients. The risk factors associated with failure of dental implant was higher in chronic periodontitis patients than patients in the periodontally healthy group (14.25% vs. 4.92%, p < 0.05). In conclusion, data in the current study indicate that inflammation is a risk indicator bone loss, implant fracture and implant failure in patients with chronic periodontitis.

Dental Implant Surgery: A Concise Review of the Literature

Edentulism is a global challenge affecting patients’ psychosocial well-being, now well-treated by dental implants. Due to the advancement in the field of oral implantology, there is a plethora of surgical techniques and protocols at the disposal of clinicians, backed by an ever-divided body of research. Treatment with dental implants has become ever more sought after because of their high survival and success rates and increased affordability. In turn, this has put increased demand on clinicians who owe their patients the highest standard of care backed by sound scientific evidence. However, dentists are expressing concern over ambiguous dental implant guidelines and protocols. Implant survival, success and failure rates have been reported differently for various modalities and justified differently in various research. This lack of consensus appears to stem from erroneous or non-standardized study designs, yielding inconsistent results. Therefore, correctly designed and well-reported high-level studies are needed to aid clinicians in treatment decision-making.

Patient and implant-related risk factors for implant failure of one-stage lateral sinus floor elevation: A 2- to 10-year retrospective study.

This retrospective study aimed to evaluate the early and late implant failure rates of one-stage lateral sinus floor elevation (LSFE)and to identify the patient and implant-related risk factors associated with these failures. All patients treated with one-stage LSFE from January 2014 to December 2021 were evaluated for inclusion. A total of 618 patients with 936 implants met the inclusion criteria. Clinical and radiographic information about patient and implants was collected. Univariate and multivariate Cox proportional hazards frailty regression models were performed to identify risk factors for early and late implant failure. The cumulative implant survival rate was 95.62% (95% CI 93.90%-97.68%), with 16 early implant failures and 25 late implant failures. The Cox analysis indicated that ≤3 mm residual bone height (RBH) was associated with a higher early failure rate. For late implant failure, smoking habit, ≤3 mm RBH, and certain implant brand were independent risk factors. Narrow sinus ostium, long infundibulum, and flat thickening of Schneiderian membrane might be non-independent risk factors for late implant failure. No significance was found in other variables, including age, periodontitis history, implant characteristics (position, diameter, length, protrusion length, marginal bone loss), surgeon experience, healing time, opposing dentition, and prosthesis. One-stage LSFE is a predictable treatment for patients with atrophic maxilla. ≤3 mm RBH increased the risk of early implant failure, while smoking habit, ≤3 mm RBH, and certain implant brand were independent risk factors for late implant failure.

Evaluation of the Tissue Immune Microenvironment in the Diabetic Patients with Dental Implant

Long-term hyperglycemia in people with diabetes very frequently leads to damage and/or dysfunction of many tissues and organs of the human body, causing increased clinical morbidity. There is, however, an increased correlation between glycemic control and the onset of these consequences and in particular microvascular and macrovascular complications. The results of some studies have suggested that diabetes exerts an influence on the failure rates of implants compared to non-diabetic patients. One study demonstrates that HbA1c level (higher or lower than the threshold of 8.1) also influences the survival rate of dental implants. Biopsy fragments from 8 consecutive patients who had a titanium dental implant as well as diabetes were included in our study. The control group was represented by 4 patients with dental implants and who did not have diabetes. After the histological processing of the tissues, cell counts of CD4, CD8, CD20 and CD3 lymphocytes were performed by using QuPath. The findings characterize the composition of lymphocyte populations in the oral mucosa surrounding dental implants. In diabetic patients, poor glycemic control has been associated with a decreased CD4/ CD8, contrary to our findings in tissue. The decreased number of CD20 positive lymphocytes could be associated with the dysfunction of humoral immunity generally observed in patients with diabetes. In our study, a 2.5 x higher value of TCD4+ lymphocytes was noted compared to the average of TCD8+ type lymphocytes. These results support the involvement of these types of inflammatory cells in the potimplant bone healing processes. This process starts on the 10th day post-implant. Different studies raise, in these cases, the question of innate immune response vs adaptive immune response. Suppression of processes induced by CD8+ lymphocytes is associated with stimulation of bone formation. Our results support this hypothesis.

Penyuluhan Dan Safari Keluarga Berencana Dalam Meningkatakan Penggunaan KB Implan Dan Iud Di Klinik Pratama Elvi Diana Kecamatan Medan Johor, Kota Medan Tahun 2024

Background: Uncontrolled population growth will have many negative impacts. The central government and regional governments have made efforts to reduce the large population growth rate. The government's efforts include socializing two children through the Family Planning program. Intrauterine Device (IUD) is a contraceptive device that is good for women. This tool is very effective and does not need to be remembered every day like birth control pills and birth control injections every month or every three months. For mothers who breastfeed, the IUD does not affect breast milk, the flow or level of breast milk (ASI). Meanwhile, an implant is a type of contraception in the form of an implant made from a type of silastic rubber containing hormones, installed in the upper arm. The implant can be used for a long term of 5 years and is reversible. The advantages of contraception are high effectiveness, implant failure rate, 1 per 100 women per year in the first 5 years, low user failure, once installed there is no need to remember anything. The implant contains levonorgestrel which is a progesterone hormone (Hasliana, 2020). The aim of this community service program (PKM) is to increase the use of implant contraception and IUD contraception at the Pratama Elvi Diana Clinic in 2024. The method used is that counseling on targets is carried out orally. The results are based on the results of the service implementation. Participants in this activity were PUS who visited the Pratama Elvi Diana Clinic totaling 42 people.

Ceramic Heads With 12/14 Titanium Sleeves Used on Manufacturer-Non-Compatible Retained Femoral Components Do Not Lead to Implant Failure in Revision Hip Arthroplasty

BackgroundCeramic femoral heads with titanium sleeves are commonly used in revision total hip arthroplasty (rTHA). Companies advise against combination with a retained femoral component from another manufacturer. However, no data are available. The aim of this study was to evaluate and compare the implant failure and revision rates of ceramic heads with a 12/14 titanium sleeve used on manufacturer-compatible versus noncompatible retained femoral components. MethodsA retrospective single-center cohort analysis was performed using a prospectively maintained institutional arthroplasty registry. We identified 439 patients who received a titanium 12/14 ceramic head during rTHA between January 1, 2007, and December 31, 2022. There were 229 manufacturer-compatible and 210 manufacturer-noncompatible retained femoral stems, according to the company's official product compatibility list. Implant failure and rerevision rates were evaluated. ResultsAfter a median follow-up of 6.6 years (IQR (interquartile range): 4.5 to 9.3), there was no significant difference (P = 0.770) in the rerevision rate between the manufacturer-compatible group (17.0%) and the noncompatible group (18.1%). Revision-free survival after rTHA was 81.2% in the manufacturer-compatible group and 78.9% in the manufacturer-noncompatible group after 15 years (P = 0.653). Most rerevisions occurred in the first year after rTHA, with 29 of 229 (12.7%) in the manufacturer-compatible group and 24 of 210 (11.4%) in the manufacturer-noncompatible group (P = 0.705). We observed only one implant failure in the manufacturer-noncompatible group, but this was not related to a mismatch problem. ConclusionsAlthough legal uncertainties remain, this study showed no increased risk of implant failure or revision rates when a ceramic femoral head, with a 12/14 titanium sleeve, was used on a noncompatible femoral stem from a manufacturer.

Cemented and Press-fit Femoral Stems for the Management of Oncologic Femoral Tumors.

Stem fixation in reconstruction after resection of femoral tumors is debated. Cemented stems offer immediate stability but risk aseptic loosening, while press-fit stems allow bone ingrowth but risk stress shielding and subsidence. Our retrospective review aimed to determine implant failure rates and their associated factors, as well as the rates of infection, debridement, and mortality for both fixation groups (cemented or press-fit stems) used in patients undergoing resection of femoral tumor disease and subsequent arthroplasty. We retrospectively studied 252 patients who underwent resection of femoral tumors and subsequent arthroplasty using cemented (n = 173; 69%) or press-fit (noncemented) (n = 79; 31%) stems between 1999 and 2020. Implant failure was the primary outcome, with secondary outcomes including rates of implant infection, debridement, and mortality. Multivariable regression was done to assess risk factors for implant failures. The study found implant failure rates of 11% and 18% for cemented stems and press-fit stems, respectively. Lower stem to diaphyseal ratios ( P = 0.024) and younger patients ( P = 0.008) were associated with a higher risk of implant failure in cemented stems. The infection rates were 14% and 10% for cemented and press-fit stems, respectively. Debridement rates were 16% and 13% for cemented and press-fit stems, respectively, while the 1-year mortality rate was 16% for cemented stems and 1.5% for press-fit stems. This study is the largest of its kind, providing patient characteristics and outcomes in both cemented and press-fit stems in the setting of reconstruction for femoral tumors. Both methods can be effective, with outcomes dependent on patient-specific factors, such as life expectancy, activity level, and body habitus, as well as proper implant fit. Additional studies of both implants and longer follow-up are required to elucidate the optimal fixation method for each individual patient. Level III, retrospective noncomparative study.

Opinion: What are the barriers to innovation in medicine?

Opinion: What are the barriers to innovation in medicine? Thomas J. Webster, PhD provides a firsthand account of the obstacles hindering innovation in medicine, covering publishing, conferences, politics, funding, universities, and industry. Innovation is hard. Such a simple word, but so many obstacles exist to innovate and, more importantly, to turn your innovation into a medical product that actually improves human health for ultimate technology validation. As I look back at my almost 25-year career innovating in medicine, I find myself continuously reflecting on how I was able to develop innovative solutions for improving medicine despite constant obstacles. One particular innovation that I am extremely proud of involves my efforts to integrate nanotechnology into orthopedic implants. How did my team and I develop nanotextured orthopedic devices now in over 30,000 patients in which zero implants have failed to date (no infection, no chronic inflammation, and no implant loosening) when the industry average shows orthopedic implant failure rates over 10%, increasing daily (Figure 1)?(1, 2)