Dental articles or abstracts of interest

Implant survival and complications

Survival rate for implants.  4592 implants followed over 1-10 years in private periodontal practice  with overall implant survival rates  for 5 and 7 years  of  99.0%, and 98.4%. 

Generalist success rates.   Evaluated  922 implants placed in 87 general practices.  Implant survival & success rates in general dental practice were lower than from academia or specialists; ( 93% implant survival at 4 years with another 18% failing due to bone loss >2mm).

Other risk factors

Risk relative to training. potential increased failures as implant therapy is adopted by surgeons of various skill set.

Unsplinted implant risk.  Multiple implants in upper molars that are not connected to each other may fail more often.

Computer guided surgery.  This article points to inherent limitations and complictions with fully guided procedure,  the technology is not a replacement for skill and training.

Penicillin Allergy .   Since penicillin or amoxicillin is a beneficial antibiotic post surgically there is a documented higher risk for implant failure in some case types if it can not be used. in particular, with certain types of implant-related procedures such as bone grafting, lateral window sinus augmentation and immediate Implant placement in extraction socket.

Peridontal diease.  If you have gum diease such as heavy bleeding of the gums  or have lost teeth to gum disease then you are at more risk for loss of your implant.  It is critical to manage the overall health including periodontal diease as part of implant treatment.

Peri implant bone loss . This summary article show stopping bone loss on failing implants is not always predictable. It is important to get referral for proper evaluation if you suspect a failing implant.

Heavy bite forces.  If you are a bruxer or heavy grinder then implant forces are higher and this can increase risk for implant failure and or progressive bone loss.

Smoking.  Smoking can afffect implant survival both by causing more complications at time of surgery  as well as  potential increase bone loss and peri implantitis over time.

 

Controversies and concepts

Socket Grafting.  There is limited long term data with the majority  of data  < 1 yr .   In a recent systematic review of Random controlled studes  and prospective cohort studies with 3months or more duration found minor difference bone  preserved vs non grafted site  height = 1.4 mm,   width = 1.8 mm

—No evidence on superior biomaterial, or procedure and No data on the consequences long-term for implant survival .

 

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