Early and late implant failure of submerged versus non‐submerged implant healing: A systematic review, meta‐analysis and trial sequential analysis

Troiano, Giuseppe; Russo, Lucio Lo; Canullo, Luigi; Ciavarella, Domenico; Muzio, Lorenzo Lo; Laino, Luigi

doi:10.1111/jcpe.12890

Cited by 52 publications

(45 citation statements)

References 47 publications

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“…In this context, a variety of factors have been associated with an increased EIL rate; examples are—but not limited to—smoking, maxillary site, male gender, short implant length, implant type/brand, number of implants, immediate placement, need of bone grafting, non‐submerged healing, history of periodontitis, the clinician and specific medication intake (Alsaadi, Quirynen, Komárek, & van Steenberghe, ; Antoun, Karouni, Abitbol, Zouiten, & Jemt, ; Berglundh, Persson, & Klinge, ; Bryant, ; Chrcanovic, Kisch, Albrektsson, & Wennerberg, ; Derks et al, ; Esposito, Grusovin, Loli, Coulthard, & Worthington, ; Hickin, Shariff, Jennette, Finkelstein, & Papapanou, ; Jemt, ; Manzano et al, ; Olate, Lyrio, de Moraes, Mazzonetto, & Moreira, ; Olmedo‐Gaya, Manzano‐Moreno, Cañaveral‐Cavero, Dios Luna‐del Castillo, & Vallecillo‐Capilla, ; Palma‐Carrió, Maestre‐Ferrín, Peñarrocha‐Oltra, Peñarrocha‐Diago, & Peñarrocha‐Diago, ; Pommer et al, ; Troiano et al, ). For example, PPI (Al Subaie et al, ; Chrcanovic, Kisch, Albrektsson, & Wennerberg, ; Wu et al, ), SSRI (Wu et al, ) and antidepressants in general (Chrcanovic et al ), which are all rather common in the elderly, have been associated with an increased risk for implant failure.…”

Section: Discussionmentioning

confidence: 99%

How old is old for implant therapy in terms of early implant losses?

Bertl

Ebner

Knibbe

et al. 2019

J Clinic Periodontology

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ObjectivesTo assess, retrospectively, whether older age has an impact on implant osseointegration when compared with younger age.MethodsAll patients ≥65 years old at implant installation, in an university setting over a time‐period of 11.5 years, with complete anamnestic data and follow‐up until prosthetic restoration were included, and any early implant loss (EIL; i.e. lack of osseointegration prior to or at the time‐point of prosthetic restoration) was recorded. Further, one implant, from each of the elderly patients, was attempted matched to one implant in a younger patient (35 to <55 years old at implant installation) from the same clinic based on (a) gender, (b) implant region, (c) smoking status and (d) bone grafting prior to/simultaneously with implant installation. The potential impact of various local and systemic factors on EIL in the entire elderly population, and in the matched elderly and younger patient group was statistically assessed.ResultsFour hundred forty‐four patients ≥65 years old (range 65.1–91.3; 56.8% female) receiving 1,517 implants were identified; 10 patients had one EIL each (implant/patient level: 0.66/2.25%). Splitting this patient cohort additionally into four age groups [65–69.9 (n = 213), 70–74.9 (n = 111), 75–79.9 (n = 80) and ≥80 (n = 40)], EIL was on the implant level 0.41, 0.83, 0.34 and 2.26%, respectively, (p = .102) and on the patient level 1.41, 2.70, 1.25 and 7.50%, respectively, (p = .104); multilevel analysis showed weak evidence of association of increasing age with higher EIL rate (p = .090). Matching was possible in 347 cases, and 5 (1.44%) and 9 (2.59%) EIL in the elderly and younger patients, respectively, were observed (p = .280). EIL could not be associated with any systemic condition or medication intake.ConclusionsElderly patients ≥65 years old presented a similarly low EIL rate as younger patients 35 to <55 years old, while patients ≥80 years old may have a slight tendency for a higher EIL rate. Hence, ageing does not seem to compromise osseointegration, and if at all, then only slightly and at a later stage of life.

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Section: Discussionmentioning

confidence: 99%

How old is old for implant therapy in terms of early implant losses?

Bertl

Ebner

Knibbe

et al. 2019

J Clinic Periodontology

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“…Patients are ready to pay the additional costs associated with computed tomography and new surgical techniques, especially those offering treatment alternatives with fewer interventions [31]. A recent systematic review, meta-analysis and sequential trial analysis of submerged versus non-submerged implant healing used implant failure as well as marginal bone level changes between submerged and non-submerged healed dental implants as the primary outcome parameters [6]. Similarly, those two outcome parameters were used in the present study for the evaluation of non-submerging.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery is heading towards minimally invasive intervention resulting in minimal postoperative morbidity, loss of working days, improved healing, and reduced operation time being the main benefits [2][3][4]. Non-submerged implant placement presents a viable alternative to staged placement in implant dentistry [5,6]. The prerequisites for such a procedure include sufficient uncompromised bone dimensions in the implantation site and ample initial insertion torque enabling the primary stability of the inserted implant [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Non-submerged implant placement presents a viable alternative to staged placement in implant dentistry [5,6]. The prerequisites for such a procedure include sufficient uncompromised bone dimensions in the implantation site and ample initial insertion torque enabling the primary stability of the inserted implant [5,6]. The principal risks of the technique are a loss of implant stability leading to inflammation and early implant failure [7].…”

Section: Introductionmentioning

confidence: 99%

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Sinus Augmentation with Simultaneous, Non-Submerged, Implant Placement Using a Minimally Invasive Hydraulic Technique

Chaushu

Better²,

Kolerman

et al. 2020

Medicina

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Background and objectives: To evaluate whether sinus augmentation, using a minimally invasive implant device, via a non-submerged surgical approach, might negatively influence the outcome. Materials and Methods: A retrospective cohort study was conducted by evaluating patients’ files, classifying them into two groups. Fifty patients (22 men 28 women) were included in the study, 25 in each group. The use of an implant device based on residual alveolar ridge height for sinus augmentation, radiographic evaluation, insertion torque, membrane perforation, post-operative healing, and a minimum of 12 months follow-up were evaluated. Results: The mean residual alveolar ridge height was 5.4 mm for the non-submerged group and 4.2 mm for the submerged group. There were no intraoperative or postoperative complications (including membrane perforations). The mean insertion torque was 45 N/cm for the study group and 20 N/cm for the control group. Complete soft tissue healing was observed within three weeks. Mean bone gain height was 8 mm for the study and 9.3 mm for the control group. All implants osseointegrated after 6–9 months of healing time. Mean follow-up was 17.5 months, range 12–36 months. Marginal bone loss at last follow-up was not statistically significantly different: 1 mm in the non-submerged vs. 1.2 mm in the submerged group. Conclusions: Submerged and non-submerged healing following maxillary sinus augmentation was comparable provided residual alveolar ridge height >5 mm and insertion torque >25 N/cm.

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“…In the last decades several risk factors for the failure of dental implants have been reported -most of them being clinical aspects of the implant treatment, medications or health conditions. Looking at the clinical risks for bone loss around implants, surgical skills or mistakes regarding the surgical protocol, such as dull burrs, high pressure while drilling or high insertion torque, different healing protocols or excess of cement can cause problems (37)(38)(39)(40). On the other hand, medications, such as bisphosphonates or antidepressants can be risk factors for infections or implant loss (41-43).…”

Section: Discussionmentioning

confidence: 99%

Microbiological Findings in Early and Late Implant Loss

Korsch

Marten

Stoll

et al. 2020

Preprint

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Background Implants are a predictable and well-established treatment method in dentistry. Nevertheless, looking at possible failures of dental implants, early and late loss have to be distinguished. This study aimed at microbiological aspects on surfaces of implants, which had to be removed.Methods 53 specimens of implants from 49 healthy patients have been examined. The groups investigated were implants that had to be removed in the period of osseointegration (early loss) or after the healing period (late loss). Data about the microbiological colonialization of the implant was collected using amplification and high throughput sequencing of the 16S rRNA gene.Results Both early and late implant loss was associated with increased levels of Fusobacterium nucleatum and Porphyromonas gingivalis. Additionally. Late lost implants showed higher bacterial diversity and in addition higher abundances of Treponema denticola and Tannerella forsythia, while microbial communities of early loss implants were very heterogeneous.Conclusions Pathogens commonly associated with severe periodontitis were found around implants that were lost after a primarily uneventful osseointegration. P. gingivalis and F. nucleatum colonized the implant surface in early and late loss and could therefore be characteristic for implant loss in general. The reasons for early losses could be multifactorial. Trial registration This study was approved by the ethical review committee of the local medical association (Institutional Review Board of the Saarland Medical Council, Germany; ID: 232/12).

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Early and late implant failure of submerged versus non‐submerged implant healing: A systematic review, meta‐analysis and trial sequential analysis

Abstract: Implants placed with a non-submerged technique have a higher risk (2%) of early failure. The power of the evidence about the effects on MBL is low, but present results seem to favour non-submerged healing, although with a very small effect size.

Cited by 52 publications

References 47 publications

How old is old for implant therapy in terms of early implant losses?

How old is old for implant therapy in terms of early implant losses?

Sinus Augmentation with Simultaneous, Non-Submerged, Implant Placement Using a Minimally Invasive Hydraulic Technique

Microbiological Findings in Early and Late Implant Loss

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