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Miller AJ, Brown LC, Wei G, Durham MR, Hulet FN, Jeyapalina S, Stoddard G, Griffin AS. Dental implant failures in Utah and US veteran cohorts. Clin Implant Dent Relat Res 2024; 26:604-614. [PMID: 38523429 DOI: 10.1111/cid.13320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION Approximately, 5.5 million dental implants are estimated to be surgically placed in the United States yearly, with an anticipated long-term failure rate ranging from 3% to 10%. At the Salt Lake City Dental Clinic within the Department of Veterans Affairs (VHA), specific protocols have been established to mandate that clinicians present every dental implant case for review by a committee. To understand the effectiveness of this approach, a comparative data analysis was undertaken to compare local dental implant failure data against national VHA data. METHODS Leveraging electronic health records of veterans spanning from 2000 to 2021, we gathered procedural records related to dental implant placement or failure, demographic information, and medical history for individuals who received dental care at various dental clinics within the nationwide VHA network. Subsequently, statistical analyses were conducted using mixed-effects Poisson regression models with cluster-robust standard errors. Incident rate ratios (IRRs) for Utah-specific and nationwide cohorts were ascertained. RESULTS The Utah VHA dental clinical data showed that there was a slightly lower prevalence of implant failure at 6.7% compared to the national cohort, which had a rate of 6.9%. The implant level failure rates were also low, with 4.20 (confidence interval [CI]: 3.68, 4.81) per 1000 implant placements per year for Utah cohorts. The adjusted IRR indicated a relative 16% reduction in risk among Utah Veterans (IRR 0.84, 95% CI [0.76-0.92]; p < 0.001). CONCLUSIONS The stringent protocols in place at Salt Lake City, which integrate evidence-based practices and expert opinion for evaluating patient suitability for dental implant placement and subsequent care, contributed to the reduced risk among Utah Dental Clinic veterans pool compared to veterans of other states.
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Affiliation(s)
- Aaron John Miller
- Research and Development, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Layne Clair Brown
- Dental Clinic, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Guo Wei
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Mark Richards Durham
- Dental Clinic, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
- Division of Prosthodontics, University of Utah School of Dentistry, Salt Lake City, Utah, USA
| | - Forest Norton Hulet
- Dental Clinic, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Sujee Jeyapalina
- Research and Development, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Greg Stoddard
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Alec Scott Griffin
- Research and Development, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
- Dental Clinic, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
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Alhamdani FY, Hassan AF, Hussein HM. Peripheral Bone Removal versus Sequential Drilling Protocol in Dental Implant Surgery: A 5-Year Retrospective Study. Eur J Dent 2024; 18:640-644. [PMID: 37995726 PMCID: PMC11132761 DOI: 10.1055/s-0043-1772675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE The aim of this study was to compare the immediate success rate between peripheral bone removal (PBR) and conventional sequential drilling protocols. MATERIALS AND METHODS Biographic data of 130 Iraqi patients who attended a private dental implant center in Baghdad between January 7, 2018 and February 30, 2023 were collected. During this period, 198 dental implant procedures were completed. The recorded data included the zone of implantation, immediate or delayed implant, sinus lift procedure, dental implant system, bone augmentation, and dental implant length and diameter. STATISTICAL ANALYSIS SPSS Ver. 25 was used for statistical analysis. Both descriptive and inferential statistics were applied. RESULTS In total, 198 dental implant procedures were performed during the study period. Of these, 104 cases were treated with the PBR protocol and 94 with the conventional drilling protocol. Out of 130 patients included in this study, 70 were treated with the PBR (IBS) technique and 60 patients were treated with the conventional dental implant systems. The early success of osseointegration reported in this study for all of the cases exceeded 93%. The PBR protocol was successful in 96 cases (92.3%), whereas early success of osseointegration in patients treated with the conventional protocol was reported in 89 cases (94.7%). The chi-squared test showed no statistically significant difference in the early success rate between the two dental implant protocols (p = 0.575). CONCLUSION In terms of immediate success, the PBR technique appears to be a reliable drilling technique. However, further longitudinal studies need to explore its potential to replace the sequential drilling protocol.
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Affiliation(s)
- Faaiz Yaqub Alhamdani
- Department of Clinical Sciences, College of Dentistry, Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq
| | - Ahmad Fliah Hassan
- Department of Oral Medicine, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
| | - Hashim Mueen Hussein
- Department of Conservative Dentistry, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
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Thompson J, Schoenbaum TR, Pannu D, Knoernschild K. Survival analysis of zirconia implant-supported, fixed complete dentures: A 5-year retrospective cohort study. J Prosthet Dent 2023:S0022-3913(23)00288-3. [PMID: 37286415 DOI: 10.1016/j.prosdent.2023.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 06/09/2023]
Abstract
STATEMENT OF PROBLEM Existing data on the mid-term to long-term survival rates of zirconia implant-supported, fixed complete dentures (Zir-IFCDs) are lacking. PURPOSE The purpose of this retrospective clinical study was to assess the prosthetic survival rate in patients treated with Zir-IFCDs. MATERIAL AND METHODS The patient record system at the Dental College of Georgia (DCG), Augusta University was searched to identify all patients treated with Zir-IFCDs from 2015 through 2022 by the DCG graduate prosthodontic, general practice residency, and Advanced Education in General Dentistry (AEGD) programs. Reasons for replacement were grouped as failure of veneering porcelain, framework fracture, implant loss, patient-driven concerns, excessive occlusal wear, and other. RESULTS A total of 67 arches were found that met the inclusion criteria, 46 maxillary and 21 mandibular. The median follow-up time was 8.5 months (interquartile range, 2.7 to 30.9 months). A total of 9 of the 67 arches were identified as having failed (4 maxillary, 5 mandibular), requiring replacement. Reasons for failure were as follows: 3 framework fractures, 2 implant losses, 2 patient-related concerns, 1 fracture of veneering porcelain, and 1 unknown. The combined survival rate (Kaplan-Meier, log-normal modeling) for Zir-IFCDs was 88.8% at 1 year and 72.5% at 5 years CONCLUSIONS: Based on the findings, the Zir-IFCDs investigated had a survival rate lower than that reported in similar studies, though higher than published results for metal-acrylic resin-IFCDs. The most common source of failure was fracture of the zirconia framework. Thickness of the zirconia framework, interocclusal space, cantilever length, occlusal force, and status of the opposing dentition may have been associated with framework failures and should be investigated further.
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Affiliation(s)
- James Thompson
- Resident, Department of Restorative Sciences, Advanced Education in Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, GA
| | - Todd R Schoenbaum
- Professor, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, GA.
| | - Darshanjit Pannu
- Program Director, Department of Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, GA
| | - Kent Knoernschild
- Department Chair, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, GA
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Carls PF, Bernasconi M, Carinci F, Lawrence M, Lambrecht JT. The use of autologous bone for augmentation procedures leads to low prevalence of peri-implantitis-a retrospective study over a 20-year period. J Craniomaxillofac Surg 2023; 51:130-138. [PMID: 36774308 DOI: 10.1016/j.jcms.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/11/2022] [Accepted: 12/27/2022] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to compare the prevalence of peri-implantitis in implants inserted into pristine bone (control) to implants where autologous bone was used for grafting procedures (study). All patients who underwent implant surgery during a 20 years interval by one maxillofacial implant surgeon and received a prosthodontic rehabilitation afterwards were eligible for inclusion in the study. Periimplant bone resorption and periimplant disease were assessed. Of 421 patients 384 (91.2%) patients responded to a recall after having been treated over a 20-year period by one maxillofacial surgeon and several dentists. A total of 110 patients had 239 implants in pristine bone, and 274 patients had 607 implants placed in combination with autologous bone grafting procedures. Mean time in function was 74 months (range 15-236 months). In all, 342 implants (34.8%) were in function for longer than 7 years. A total of 64 implant sites (7.6%) in 39 patients (10.2%) showed signs of peri-implant mucositis. In addition, 17 implants (2.0%) in 14 patients (3.6%) revealed signs of peri-implantitis, of which five implants were in the control group (2.09%) whereas 12 implants were in the study group (1.98%), with no statistically significant difference (p = 0.8405). More than half of the patients with peri-implantitis had a history of periodontitis. Three implants were lost due to peri-implantitis and four implants failed for other reasons, resulting in an overall success rate of 99.2% in 846 implants. CONCLUSIONS: Within the limitations of the study it seems that the use of autologous bone still is a relevant option when performing augmentation procedures because of the low prevalence of peri-implantitis.
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Affiliation(s)
- Peter F Carls
- Oxford University Hospitals & Oral & Maxillofacial Surgery Practice, Oxford, United Kingdom.
| | - Marco Bernasconi
- Zurich University Dental School & Private Dental Practice, Zurich, Switzerland
| | - Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy
| | - Mark Lawrence
- Private Dental Practice, Wallingford, Oxfordshire, United Kingdom
| | - J Thomas Lambrecht
- Department of Oral Surgery, Oral Radiology and Oral Medicine, University Center for Dental Medicine Basel, University of Basel, Switzerland
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Dental implant failure and factors associated with treatment outcome: A retrospective study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 124:101314. [PMID: 36280552 DOI: 10.1016/j.jormas.2022.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/26/2022] [Accepted: 10/16/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of the present study was to retrospectively 1) investigate the association between implant-, patient- and bone-related parameters with the risk of implant failure; 2) analyze the survival rates of dental implants placed in a university clinical setting. METHODS Data were retrieved from patient charts from the University of Minnesota School of Dentistry to identify patients older than 18 years of age who received dental implant treatment by faculty, residents or students in the university dental clinics. Implant-, patient- and bone-related parameters such as implant system, length, diameter, jaw, region, installation protocol, gender, smoking, medical history, history of periodontal disease, self-reported oral parafunctions, type of bone, and operator were manually retrieved and analyzed. RESULTS Five hundred and fifty-three implants were randomly selected from a total of 4,424. Of these 553 implants, 440 (79.6%) were associated with a >10 mm length, 371 (67.1%) with a >4 mm diameter and 431 (77.9%) had replaced a single tooth. Submerged healing mode was followed in 363 (65.6%) of the implants with the mean healing time being 3.2 months. History of periodontal disease was identified in 294 (53.2%) of these cases. A total of 17 implants failed after a mean time of 6.29 ± 6.75 months, resulting in an overall survival rate of 96.9%. Based on a univariate analysis, implant system, operator, time between extraction and implant surgery, time between bone grafting and implant placement, tobacco use as well as clenching and grinding were considered potential implant failure predictors and were further included in the multivariate logistic regression analysis. Tobacco use (p < 0.001) was significantly associated with implant failure. CONCLUSION Within the limitations of this retrospective randomly selected university-treated sample tobacco use increased the risk for implant failure. Failure occurred in 17 implants representing a 3.1% failure rate.
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Kim YM, Lee JB, Um HS, Chang BS, Lee JK. Long-term effect of implant-abutment connection type on marginal bone loss and survival of dental implants. J Periodontal Implant Sci 2022; 52:496-508. [PMID: 36468468 PMCID: PMC9807847 DOI: 10.5051/jpis.2200960048] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/02/2022] [Accepted: 05/17/2022] [Indexed: 01/07/2023] Open
Abstract
PURPOSE This study aimed to compare the long-term survival rate and peri-implant marginal bone loss between different types of dental implant-abutment connections. METHODS Implants with external or internal abutment connections, which were fitted at Gangneung-Wonju National University Dental Hospital from November 2011 to December 2015 and followed up for >5 years, were retrospectively investigated. Cumulative survival rates were evaluated for >5 years, and peri-implant marginal bone loss was evaluated at 1- and 5-year follow-up examinations after functional loading. RESULTS The 8-year cumulative survival rates were 93.3% and 90.7% in the external and internal connection types, respectively (P=0.353). The mean values of marginal bone loss were 1.23 mm (external) and 0.72 mm (internal) (P<0.001) after 1 year of loading, and 1.20 mm and 1.00 mm for external and internal abutment connections, respectively (P=0.137) after 5 years. Implant length (longer, P=0.018), smoking status (heavy, P=0.001), and prosthetic type (bridge, P=0.004) were associated with significantly greater marginal bone loss, and the use of screw-cement-retained prosthesis was significantly associated (P=0.027) with less marginal bone loss. CONCLUSIONS There was no significant difference in the cumulative survival rate between implants with external and internal abutment connections. After 1 year of loading, marginal bone loss was greater around the implants with an external abutment connection. However, no significant difference between the external and internal connection groups was found after 5 years. Both types of abutment connections are viable treatment options for the reconstruction of partially edentulous ridges.
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Affiliation(s)
- Young-Min Kim
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Jong-Bin Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Heung-Sik Um
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Beom-Seok Chang
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Jae-Kwan Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
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