A systematic review and meta-analysis on influencing factors of failure of oral implant restoration treatment

Abstract

Background: With the continuous improvement of human living standards, more and more dental patients are requiring oral implant restoration treatment. However, there is still controversy regarding the influence of risk factors such as osteoporosis, radiotherapy, diabetes, and smoking on the failure of oral implants. This study aimed to explore the correlation between risk factors and failure of oral implant restoration treatment. Methods:The databases of China National Knowledge Infrastructure (CNKI), Baidu Academic, Weipu, Wanfang, PubMed, EBSCO, Medline, Web of knowledge, Ovid, and the Cochrane Library were searched.The search strategies included: subject terms related to research results such as survival, osseointegration, failure, removal, replacement, and loss; related to risk factors: osteoporosis, head and neck cancer, diabetes, and smoking; and oral implantology as a keyword.Results: Thirty-two articles were included in meta-analysis, there was a high heterogeneity between radiotherapy and dental implant failure (I 2 =71.6%, P=0.000), and there was an obvious correlation between radiotherapy and dental implant failure [relative risk (RR) =2.09, 95% confidential interval (CI): 1.68-2.61].There was heterogeneity between diabetes and oral implant failure in the included articles (I 2 =59.6%, P=0.084). There was no remarkable correlation between osteoporosis and dental implant failure (RR =1.19, 95% CI: 0.81-1.74). There was a high heterogeneity between smoking and dental implant failure in the included articles (I 2 =33.8%, P=0.092), showing obvious correlation (RR =1.80, 95% CI: 1.53-2.11).Discussion: The results of meta-analysis confirmed that radiotherapy and smoking were greatly associated with oral implant failure.

Radioterapia y riesgo de supervivencia en implantes dentales: Resumen de revisiones sistemáticas.

“…En la Tabla I se muestran los principales hallazgos de las revisiones analizadas, donde Lu y cols. 4 reportan una correlación entre la RT y el fracaso de los implantes dentales (riesgo relativo [RR] = 2,09, intervalo de confianza [IC] del 95 %: 1,68 a 2,61), siendo este factor de riesgo ratificado por:  Gupta y cols. 2 , quienes muestran que los implantes colocados sobre tejido óseo no irradiado tienen una tasa de supervivencia mayor (93,9 %) a los implantes en zonas irradiadas (85,8 %), siendo los efectos adversos y el fracaso de los implantes relacionado a sitios irradiados con un Odds Ratio (OR) de 2,95 (IC 95 %; 1,93 a 4,50) luego de entre 6 a 120 semanas.…”

“…a los 50 Grays (Gy) se ha posicionado como el segundo método más utilizado de tratamiento solo superado por el procedimiento quirúrgico [1][2][3][4][5][6] .…”

“…En este sentido, se ha sugerido a la rehabilitación dental con implantes osteointegrados como el estándar de oro para el tratamiento de insatisfacciones de comunicación y masticación vinculadas al cáncer. No obstante, a pesar de esto, aún existe reticencia en torno a su uso debido a algunas contraindicaciones sobre el proceso de osteointegración (retención, estabilidad, funcionalidad y estética del implante) [1][2][3][4][5][6][7] . Respecto a esto, se sabe que la RT destruye los osteoblastos, además de generar disminuciones sobre la vascularización, pudiendo conducir al desarrollo de osteorradionecrosis [1][2][3][4][5][6] .…”

“…En la actualidad existen muchos interrogantes en torno a los tiempos de implantación y supervivencia en función del sitio de implantación, donde los tratamientos post-RT se han vuelto un eslabón fundamental para la obtención de respuestas, tanto a mediano como largo plazo, siendo el rol de los implantes en base a titanio fundamental para la delineación tumoral en dientes adyacentes 3,4,8,9 .…”

Prognosis of Implants with Implant-Supported Fixed Dental Prostheses in the Elderly Population: A Retrospective Study with a 5- to 10-Year Follow-Up

“…In this case, the implant was placed in the bone and was scheduled to be resected. However, chemotherapy and radiotherapy in the craniofacial area has an adverse effect on the prognosis of an implant placed even at the distant site to tumor [ 40 ]. In such cases, the prevention of peri-implant mucositis and subsequent peri-implantitis should be considered.…”