Factors Associated with Failure of Surface-Modified Implants up to Four Years of Function

• Published in: Clinical implant dentistry and related research 2012-06, Vol.14 (3), p.347-358
• Main Authors: Cosyn, Jan, Vandenbulcke, Edward, Browaeys, Hilde, Van Maele, Georges, De Bruyn, Hugo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bone Transplantation; Chi-Square Distribution; Clinical Competence; Cross-Sectional Studies; Dental Implantation - education; Dental Implantation, Endosseous - methods; Dental Implants - adverse effects; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Dentistry; Female; Humans; Immediate Dental Implant Loading - adverse effects; implant characteristics; implant failure; Kaplan-Meier Estimate; loading protocol; Male; Middle Aged; postgraduate training; Proportional Hazards Models; Retrospective Studies; risk indicators; Surface Properties; surgical experience; Young Adult
• ISSN: 1523-0899; 1708-8208
• DOI: 10.1111/j.1708-8208.2010.00282.x

ABSTRACT Objectives: The relative impact of innovative treatment concepts on the failure of surface‐modified implants is not well understood. This retrospective study aimed to explore this using data obtained in a university postgraduate training center. Material and Methods: Patients treated with implants for a variety of indications over a 3‐year period were included. All implants had been at least 1 year in function. Clinical records were evaluated for implant failure and in reference to implant length/diameter/location, time from tooth loss to implant placement, bone condition (native/grafted), surgical protocol (two‐/one‐stage), loading protocol (delayed/early/immediate), type of prosthesis (removable/fixed), surgeon's experience level (resident/trainee) and specialty (periodontist/oral surgeon). The impact of each covariate on failure was tested using the Fisher's exact test. Kaplan‐Meier survival functions were constructed and Mantel‐Cox log–rank tests were used to compare survival functions. To correct for possible interaction, Cox proportional Hazards regression was adopted. Results: Forty‐one of 1,180 (3.5%) implants were lost in 34/461 (7.4%) patients (245 ♀, 216 ♂; mean age 51, range 18–90). Factors showing significant impact on failure on the basis of univariate analyses were implant location (p = .015), surgical protocol (p = .002), loading protocol (p = .002), surgeon's experience level (p = .035) and specialty (p = .001). When controlling for other covariates, only the loading protocol had a significant influence (p = .049) with early loading more prone to failure (p = .014) when compared with delayed loading. Immediate loading and delayed loading showed comparable implant survival (p = .311). Conclusions: Implant therapy may be highly successful in a training center where inexperienced clinicians are strictly monitored and personally guided. Implant specific variables do not affect implant survival but early loading is a risk indicator for implant failure, whereas immediate loading is not.