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Östman PO, Chrcanovic BR, Albrektsson T. A Prospective Report of the Clinical Outcome of TiUnite Implants at 20 Years of Follow-Up. Int J Oral Maxillofac Implants 2024; 0:1-18. [PMID: 38607359 DOI: 10.11607/jomi.10654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
PURPOSE The purpose of this paper is to present a survival analysis of 133 consecutively placed moderately rough implants, all with a total follow up of 20 years. MATERIALS AND METHODS A total of 133 implants of the same brand placed in 46 patients at the same county clinic of Sweden have been followed up prospectively over 20 years and analyzed for survival and bone height, the latter evaluated in peri-apical radiographs. RESULTS A total of 7 implants failed, of which 4 failures were seen in the same patient. The reason for implant failure was associated with a combination of patient smoking and bruxing in 5 of the 7 failed cases. A 20- year survival rate of 94.7% was observed. Average marginal bone loss(mbl) at 20 years of follow up was 0.543 ±1.193 mm with 9 implants having more than 2 mm mbl . A total of 20 patients with 25 implants dropped out of the study, but if patient death as drop-out reason is ignored only 3 implants in 3 patients were unaccounted for. CONCLUSION Good clinical results in the 95% survival range were observed with moderately rough implants over a 20 year follow up time.
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Chrcanovic BR, Gomez RS. Response to Letter to the Editor - "Gorham- Stout disease with involvement of the jaws: a systematic review". Int J Oral Maxillofac Surg 2019; 49:546. [PMID: 31630907 DOI: 10.1016/j.ijom.2019.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/02/2019] [Indexed: 11/19/2022]
Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - R S Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Chrcanovic BR, Gomez RS. Juvenile ossifying fibroma of the jaws and paranasal sinuses: a systematic review of the cases reported in the literature. Int J Oral Maxillofac Surg 2019; 49:28-37. [PMID: 31285096 DOI: 10.1016/j.ijom.2019.06.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/09/2019] [Accepted: 06/26/2019] [Indexed: 10/26/2022]
Abstract
The aim was to compare clinical and radiological features of the two juvenile ossifying fibroma (JOF) variants, trabecular (JTOF) and juvenile psammomatoid ossifying fibroma (JPOF). An electronic search was undertaken in March 2019. Eligibility criteria included publications having sufficient clinical, radiological, and histological information to confirm the diagnosis. A total of 185 publications and 491 cases were included. Most JOFs, including both variants, showed bone expansion, were painless, presented no cortical perforation and no secondary aneurysmal bone cyst, did not cause tooth root resorption, and had a mixed unilocular radiodensity appearance and well-defined limits on radiological examination. Patients with JPOF were on average older than those with JTOF. Enucleation and curettage was associated with a considerably high recurrence rate, regardless of the anatomical location or variant type of the lesion. Enucleation followed by either curettage or peripheral osteotomy showed lower recurrence rates than enucleation only. When resection was performed, only one case of JTOF presented recurrence. In conclusion, JOF lesions presented high rates of recurrence after treatment by curettage and enucleation only. Although surgical resection of JOFs resulted in the virtual absence of recurrence, enucleation followed by peripheral osteotomy/curettage should be the treatment of choice for both JOF variants to avoid the disfigurement usually associated with surgical resection.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - R S Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Chrcanovic BR, Gomes CC, Gomez RS. Peripheral giant cell granuloma associated with dental implants: a systematic review. J Stomatol Oral Maxillofac Surg 2019; 120:456-461. [PMID: 30677564 DOI: 10.1016/j.jormas.2019.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
The purpose of the present review was to integrate the available published data on peripheral giant cell granuloma (PGCG) associated with dental implants into a comprehensive analysis of its clinical/radiologic features. An electronic search was undertaken in February/2018 in three databases, looking for publications reporting cases of PGCGs associated with dental implants. Nineteen publications were included, reporting 37 implant-associated PGCG. These lesions are more prevalent in women, in mandible, and in posterior regions of the jaws. Both 'excision alone' and 'excision + curettage' presented high recurrence rates (40% and 31.3%, respectively). The etiology of implant-associated PGCG has not yet been determined. Despite the small number of cases reported, implant-associated PGCG shows a high recurrence rate (1/3) for a benign non-neoplastic lesion and sometimes it requires the removal of the associated implant in order to prevent further recurrences. This recurrence rate is not affected by curettage after excision.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - Carolina C Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas-Gerais, Belo Horizonte, Brazil.
| | - R S Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas-Gerais, Belo Horizonte, Brazil.
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Chrcanovic BR, Gomez RS. Melanotic neuroectodermal tumour of infancy of the jaws: an analysis of diagnostic features and treatment. Int J Oral Maxillofac Surg 2018; 48:1-8. [PMID: 30170777 DOI: 10.1016/j.ijom.2018.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/26/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
The purpose of this study was to integrate the available published data on melanotic neuroectodermal tumour of infancy (MNTI) of the jaws into a comprehensive analysis of its clinical/radiological features, with emphasis on the predictive factors associated with recurrence. Eligibility criteria included publications with sufficient clinical/radiological/histological information to confirm the diagnosis. A total of 288 publications reporting 429 MNTI cases were included. MNTIs were slightly more prevalent in males and markedly more prevalent in the maxilla. Most of the lesions were asymptomatic, presenting cortical bone perforation and tooth displacement. Nine lesions were malignant, with metastasis in five cases. Enucleation was the predominant treatment (67.2%), followed by marginal (18.4%) and segmental resection (6.1%). Eighty-one of 356 lesions (22.8%) recurred. Recurrence rates were 61.5% for curettage, 25.3% for enucleation alone, 16.2% for enucleation+curettage, 20.0% for enucleation+peripheral osteotomy, 11.3% for marginal resection, 10.0% for segmental resection, 30.0% for chemotherapy, and 33.3% for radiotherapy. Enucleation and resection presented significantly lower recurrence rates in comparison to curettage. Curettage appears not to be the best form of treatment, due to its high recurrence rate. As resection (either marginal or segmental) is associated with higher morbidity, enucleation with or without complementary treatment (curettage or peripheral osteotomy) would appear to be the most indicated therapy.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - R S Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Chrcanovic BR, Gomez RS. Gingival cyst of the adult, lateral periodontal cyst, and botryoid odontogenic cyst: An updated systematic review. Oral Dis 2018; 25:26-33. [PMID: 29156092 DOI: 10.1111/odi.12808] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/11/2017] [Accepted: 11/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- BR Chrcanovic
- Department of ProsthodonticsFaculty of OdontologyMalmö University Malmö Sweden
| | - RS Gomez
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais Belo Horizonte Brazil
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Chrcanovic BR, Gomez RS. Glandular odontogenic cyst: An updated analysis of 169 cases reported in the literature. Oral Dis 2017; 24:717-724. [PMID: 28744957 DOI: 10.1111/odi.12719] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/27/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - R S Gomez
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
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Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Is the intake of selective serotonin reuptake inhibitors associated with an increased risk of dental implant failure? Int J Oral Maxillofac Surg 2017; 46:782-788. [PMID: 28222946 DOI: 10.1016/j.ijom.2017.01.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/22/2016] [Accepted: 01/26/2017] [Indexed: 11/28/2022]
Abstract
The aim of this retrospective study was to investigate the association between the intake of selective serotonin reuptake inhibitors (SSRIs) and the risk of dental implant failure. Patients were included if they were taking SSRIs only and no other medication, did not present any other systemic condition or compromising habits (bruxism, smoking, snuff), and complied with the use of prophylactic antibiotics for implant surgery. The multivariate generalized estimating equation (GEE) method and multilevel mixed-effects parametric survival analysis were used to test the association between SSRI exposure (predictor variable) and the risk of implant failure (outcome variable), adjusting for several potential confounders (other variables). The total number of implants with information available and meeting the necessary eligibility criteria was 931 (35 failures). These were placed in 300 patients. The implant failure rate was 12.5% for SSRI users and 3.3% for non-users (P=0.007). Kaplan-Meier analysis showed a statistically significant difference in the cumulative survival rate (P<0.001). The multivariate GEE model did not show a statistically significant association between SSRI intake and implant failure (P=0.530), nor did the multilevel model (P=0.125). It is suggested that the intake of SSRIs may not be associated with an increased risk of dental implant failure.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - J Kisch
- Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Biomaterials, Gothenburg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Response to the Letter to the Editor: "Factors Influencing Early Dental Implant Failures". J Dent Res 2016; 96:118. [PMID: 27864468 DOI: 10.1177/0022034516680158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- B R Chrcanovic
- 1 Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - J Kisch
- 2 Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - T Albrektsson
- 1 Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,3 Department of Biomaterials, Gothenburg University, Göteborg, Sweden
| | - A Wennerberg
- 1 Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach. J Oral Rehabil 2016; 43:813-823. [PMID: 27611304 DOI: 10.1111/joor.12431] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2016] [Indexed: 11/28/2022]
Abstract
Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13·0% (24/185) for bruxers and 4·6% (155/3364) for non-bruxers (P < 0·001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3·396; 95% CI 1·314, 8·777; P = 0·012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden. ,
| | - J Kisch
- Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abstract
The aim of this meta-analysis was to test the null hypothesis of no difference in the implant failure rates, marginal bone loss (MBL)and post-operative infection for patients being rehabilitated by turned versus anodised-surface implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in November 2015. Eligibility criteria included clinical human studies, either randomised or not. Thirty-eight publications were included. The results suggest a risk ratio of 2·82 (95% CI 1·95-4·06, P < 0·00001) for failure of turned implants, when compared to anodised-surface implants. Sensitivity analyses showed similar results when only the studies inserting implants in maxillae or mandibles were pooled. There were no statistically significant effects of turned implants on the MBL (mean difference-MD 0·02, 95%CI -0·16-0·20; P = 0·82) in comparison to anodised implants. The results of a meta-regression considering the follow-up period as a covariate suggested an increase of the MD with the increase in the follow-up time (MD increase 0·012 mm year(-1) ), however, without a statistical significance (P = 0·813). Due to lack of satisfactory information, meta-analysis for the outcome 'post-operative infection' was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abstract
The purpose of the present study was to assess the influence of local and systemic factors on the occurrence of dental implant failures up to the second-stage surgery (abutment connection). This retrospective study is based on 2,670 patients who received 10,096 implants and were consecutively treated with implant-supported prostheses between 1980 and 2014 at 1 specialist clinic. Several anatomic-, patient-, health-, and implant-related factors were collected. Descriptive statistics were used to describe the patients and implants. Univariate and multivariate logistic regression models were used at the patient level as well as the implant level to evaluate the effect of explanatory variables on the failure of implants up to abutment connection. A generalized estimating equation method was used for the implant-level analysis to account for the fact that repeated observations (several implants) were available for a single patient. Overall, 642 implants (6.36%) failed, of which 176 (1.74%) in 139 patients were lost up to second-stage surgery. The distribution of implants in sites of different bone quantities and qualities was quite similar between implants lost up to and after abutment connection. Smoking and the intake of antidepressants were the statistically significant predictors in the multivariate model (ClinicalTrials.gov NCT02369562).
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - J Kisch
- Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Chrcanovic BR, Albrektsson T, Wennerberg A. Dental implants inserted in male versus female patients: a systematic review and meta-analysis. J Oral Rehabil 2015; 42:709-22. [PMID: 25989467 DOI: 10.1111/joor.12308] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2015] [Indexed: 12/14/2022]
Affiliation(s)
- B. R. Chrcanovic
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - T. Albrektsson
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
- Department of Biomaterials; Göteborg University; Göteborg Sweden
| | - A. Wennerberg
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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Chrcanovic BR, Albrektsson T, Wennerberg A. Immediately loaded non-submerged versus delayed loaded submerged dental implants: a meta-analysis. Int J Oral Maxillofac Surg 2014; 44:493-506. [PMID: 25541014 DOI: 10.1016/j.ijom.2014.11.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 09/19/2014] [Accepted: 11/19/2014] [Indexed: 10/24/2022]
Abstract
The purpose of the present meta-analysis was to test the null hypothesis of no difference in the implant failure rate, postoperative infection, and marginal bone loss for patients being rehabilitated with immediately loaded non-submerged dental implants or delayed loaded submerged implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 28 publications. The inverse variance method was used for a random- or fixed-effects model, depending on the heterogeneity. The estimates of an intervention were expressed as the risk ratio (RR) and mean difference (MD) in millimetres. Twenty-three studies were judged to be at high risk of bias, one at moderate risk of bias, and four studies were considered at low risk of bias. The difference between procedures (submerged vs. non-submerged implants) significantly affected the implant failure rate (P = 0.02), with a RR of 1.78 (95% confidence interval (CI) 1.12-2.83). There was no apparent significant effect of non-submerged dental implants on the occurrence of postoperative infection (P = 0.29; RR 2.13, CI 0.52-8.65) or on marginal bone loss (P = 0.77; MD -0.03, 95% CI -0.23 to 0.17).
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Chrcanovic BR, Albrektsson T, Wennerberg A. Prophylactic antibiotic regimen and dental implant failure: a meta-analysis. J Oral Rehabil 2014; 41:941-56. [PMID: 25040894 DOI: 10.1111/joor.12211] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2014] [Indexed: 12/20/2022]
Abstract
The aim of this meta-analysis was to investigate whether there are any positive effects of prophylactic antibiotic regimen on implant failure rates and post-operative infection when performing dental implant treatment in healthy individuals. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomised or not. The search strategy resulted in 14 publications. The I(2) statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used with a fixed- or random-effects model, depending on the heterogeneity. The estimates of relative effect were expressed in risk ratio (RR) with 95% confidence interval. Six studies were judged to be at high risk of bias, whereas one study was considered at moderate risk, and six studies were considered at low risk of bias. The test for overall effect showed that the difference between the procedures (use versus non-use of antibiotics) significantly affected the implant failure rates (P = 0.0002), with a RR of 0.55 (95% CI 0.41-0.75). The number needed to treat (NNT) to prevent one patient having an implant failure was 50 (95% CI 33-100). There were no apparent significant effects of prophylactic antibiotics on the occurrence of post-operative infections in healthy patients receiving implants (P = 0.520). A sensitivity analysis did not reveal difference when studies judged as having high risk of bias were not considered. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö
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Abstract
The aim of this systematic review and meta-analysis was to investigate whether there are any effects of diabetes mellitus on implant failure rates, postoperative infections, and marginal bone loss. An electronic search without time or language restrictions was undertaken in March 2014. The present review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligibility criteria included clinical human studies. The search strategy resulted in 14 publications. The I (2) statistic was used to express the percentage of total variation across studies due to heterogeneity. The inverse variance method was used for the random effects model when heterogeneity was detected or for the fixed effects model when heterogeneity was not detected. The estimates of an intervention for dichotomous outcomes were expressed in risk ratio and in mean difference in millimeters for continuous outcomes, both with a 95% confidence interval. There was a statistically significant difference (p = .001; mean difference = 0.20, 95% confidence interval = 0.08, 0.31) between diabetic and non-diabetic patients concerning marginal bone loss, favoring non-diabetic patients. A meta-analysis was not possible for postoperative infections. The difference between the patients (diabetic vs. non-diabetic) did not significantly affect implant failure rates (p = .65), with a risk ratio of 1.07 (95% confidence interval = 0.80, 1.44). Studies are lacking that include both patient types, with larger sample sizes, and that report the outcome data separately for each group. The results of the present meta-analysis should be interpreted with caution because of the presence of uncontrolled confounding factors in the included studies.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abstract
This study reviews the literature regarding the factors contributing to failures of dental implants. An electronic search was undertaken including papers from 2004 onwards. The titles and abstracts from these results were read to identify studies within the selection criteria. All reference lists of the selected studies were then hand-searched, this time without time restrictions. A narrative review discussed some findings from the first two parts where separate data from non-comparative studies may have indicated conclusions different from those possible to draw in the systematic analysis. It may be suggested that the following situations are correlated to increase the implant failure rate: a low insertion torque of implants that are planned to be immediately or early loaded, inexperienced surgeons inserting the implants, implant insertion in the maxilla, implant insertion in the posterior region of the jaws, implants in heavy smokers, implant insertion in bone qualities type III and IV, implant insertion in places with small bone volumes, use of shorter length implants, greater number of implants placed per patient, lack of initial implant stability, use of cylindrical (non-threaded) implants and prosthetic rehabilitation with implant-supported overdentures. Moreover, it may be suggested that the following situations may be correlated with an increase in the implant failure rate: use of the non-submerged technique, immediate loading, implant insertion in fresh extraction sockets, smaller diameter implants. Some recently published studies suggest that modern, moderately rough implants may present with similar results irrespective if placed in maxillas, in smoking patients or using only short implants.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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