Monte Carlo simulation of reasons for early failure of implants: effects of two risk factors

Buhara, Oğuz; Pehlivan, Salahi

doi:10.1016/j.bjoms.2018.11.011

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…Therefore, the sensitivity of the variables (risk factors) increases proportionally with the increasing uncertainty on the outcome (flare-up risk). Spearman's rank order correlation was calculated by @Risk software to analyze the sensitivity of the risk factors with respect to their SRF is values [22].…”

Section: Monte Carlo Simulation Modelingmentioning

confidence: 99%

The top risk factors for endodontic flare-up: a Monte Carlo simulation

Aksoy

Pehlivan²,

Buhara

2020

Clin Oral Invest

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Objectives The aim of this study was to analyze the strength of risk factors related to endodontic flare-ups and rank them in order of their importance Materials and methods A systematic literature search of PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web of Knowledge, and grey literature was conducted up to November 2019. One hundred ninety-eight publications were identified. Twelve records fulfilled the eligibility criteria, and eight significant risk factors for flare-up, namely, "Periapical lesion," "multiple-visit treatment," "preoperative pain," "necrotic teeth," "female gender," "retreatment," "percussion pain," and "analgesics," were selected to construct the simulation model. The final data pool was established by the integration of data of common risk factors in the included articles. Monte Carlo method was used to analyze of combined numerical data, for simulation of the risk factor impacts. Ten thousand iterations were generated in the simulation model. Results The results of the simulation revealed that the risk estimates of the factors had varying ranges of influence and probability on the flare-up risk. "Periapical lesion" was found to be the most sensitive risk factor, following by "preoperative pain" which was ranked the second place. The third-ranked risk factor was "multiple-visit treatment." The least sensitive risk factors for endodontic flare-up were "retreatment," "female gender," "necrotic teeth," and "analgesics." Conclusions The present study provides better comprehension on the importance of risk factors for flare-up based on their risk estimates. Clinical relevance A Monte Carlo simulation was adopted to identify the most influential risk factors for endodontic flare-up with a ranking, which can be used to provide meaningful predictions and further insights into clinicians' perception of flare-up risk.

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Section: Monte Carlo Simulation Modelingmentioning

confidence: 99%

The top risk factors for endodontic flare-up: a Monte Carlo simulation

Aksoy

Pehlivan²,

Buhara

2020

Clin Oral Invest

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“…In this context, reporting on the timepoint and/or cause of implant loss/failure was often unclear; obviously, the timepoint of implant loss can be indicative of the reason, and implant loss prior to‐ or within the first year of prosthetic loading should not be considered as the result of peri‐implantitis, but as early failures due to compromised osseointegration from other factors (e.g. smoking) (Buhara, & Pehlivan, 2018, 2019; Jemt, & Häger, 2006). Two publications from the same research group, both considered of moderate methodological quality, reporting on one PC with 5 years follow‐up time (Friberg, & Jemt, 2015) and one RS with up to 30 years follow‐up time (Jemt, 2020), including more than 4000 patients and around 16,000 implants in total, presented statistically significantly increased failure rates for implants with a turned surface compared with those with a modified surface.…”

Section: Discussionmentioning

confidence: 99%

What is the influence of implant surface characteristics and/or implant material on the incidence and progression of peri‐implantitis? A systematic literature review

Stavropoulos

Bertl

Winning

et al. 2021

Clinical Oral Implants Res

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Objectives To answer the focused question, ‘In animals or patients with dental implants, does implant surface characteristics and/or implant material have an effect on incidence and progression of peri‐implantitis?’ Material and Methods Pre‐clinical in vivo experiments on experimental peri‐implantitis and clinical trials with any aim and design, and ≥5 years follow‐up, where the effect of ≥2 different type of implant material and/or surface characteristics on peri‐implantitis incidence or severity, and/or progression, implant survival or losses due to peri‐implantitis, and/or marginal bone levels/loss was assessed. Results Meta‐analyses based on data of pre‐clinical experiments, using the ligature induced peri‐implantitis model in the dog, indicated that after the spontaneous progression phase implants with a modified surface showed significantly greater radiographic bone loss (effect size 0.44 mm; 95%CI 0.10–0.79; p = .012; 8 publications) and area of infiltrated connective tissue (effect size 0.75 mm2; 95%CI 0.15–1.34; p = .014; 5 publications) compared to non‐modified surfaces. However, in 9 out of the 18 included experiments, reported in 25 publications, no significant differences were shown among the different implant surface types assessed. Clinical and/or radiographic data from 7605 patients with 26,188 implants, reported in 31 publications (20 RCTs, 3 CTs, 4 prospective cohort, and 4 retrospective studies; 12 with follow‐up ≥10 years), overall did not show significant differences in the incidence of peri‐implantitis, when this was reported or could be inferred, among the various implant surfaces. In general, high survival rates (90–100%) up to 30 years and no clinically relevant differences in marginal bone loss/levels, merely compatible with crestal remodelling, were presented for the various implant types. Conclusion Pre‐clinical in vivo experiments indicate that surface characteristics of modified implants may have a significant negative impact on peri‐implantitis progression, while clinical studies do not support the notion that there is a difference in peri‐implantitis incidence among the various types of implant surfaces. No assumptions can be made regarding the possible impact of implant material on incidence and/or peri‐implantitis progression due to limited information.

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“…[39] As it has already been mentioned, most researchers consider periodontitis a risk factor for implant loss and peri-implantitis. [56789] Moreover, patients with periodontitis have a higher implant-bone loss and biological complications. [404142] This issue was even discussed in the House of Lords, which indicates how serious a problem it is with conclusions that the placement of implants in patients with periodontal disease is not a treatment that should be performed without full periodontal assessment and stabilization of periodontal disease first,[43] which clearly denies the possibility of immediate implant placement in such cases not to mention functional immediate loading.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, there are many studies and systematic reviews with meta-analyses showing strong evidence that history of periodontitis is a risk factor for such complications as implant loss, peri-implantitis, and implant bone-loss. [56789] Despite that, some researchers took the risk and conducted studies in periodontally compromised patients and provided encouraging results. [10111213] Meyle et al reported survival rates of 100% and 92.3% for the implants in the mandible and in the maxilla respectively,[10] Graetz et al in their retrospective cohort study reported a 5-year success rate of 97% of implant treatment for patients with and without chronic periodontitis and what is more, after a 10-year follow-up, the success rate in periodontally compromised patients was 93%, which was higher than in the control group where it was 91%.…”

Section: Introductionmentioning

confidence: 99%

Immediately loaded bicortical implants inserted in fresh extraction and healed sites in patients with and without a history of periodontal disease

Pałka¹,

Lazarov²

2019

Ann Maxillofac Surg

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Background:Bicortical screw implants may be used in both healed bone and fresh extraction sockets and loaded immediately. To date, there have not been too many studies reporting clinical results of such screws used in periodontally involved sites. This study aimed to assess many aspects of bicortical screw implants used to retain full-arch and segmental cemented prostheses in the rehabilitation of the mandible and maxilla in patients with or without a history of periodontal disease.Materials and Methods:This retrospective review involved 87 patients, of whom 77 had a history of periodontitis diagnosed before implant placement and 10 did not. They were treated following the same surgical procedure and received a total of 1019 implants which were immediately loaded with fixed prosthetic works.Results:A total of 1019 polished surface, one-piece, bicortical screw implants were used in 87 patients who underwent the same surgical treatment, i.e., tooth extraction and immediate implant placement were investigated, of which 526 were placed in the healed bone and 493 in fresh extraction sockets with the mean follow-up time of 22.2 ± 7.3 months. Results were analyzed using log-rank test, the Kaplan–Meier method, Chi-square test, and t-test. Cumulative survival at 12, 24, and 35 months after placement was 99.3%, 98.6%, and 97.0%, respectively.Conclusion:Bicortical smooth surface implant concept with immediate loading protocol provided predictable outcomes and survival rate of 99% in patients with and without a history of periodontitis. More studies are needed to further support the clinical advantages of bicortical anchoraged smooth surface implants.

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Monte Carlo simulation of reasons for early failure of implants: effects of two risk factors

Cited by 10 publications

References 30 publications

The top risk factors for endodontic flare-up: a Monte Carlo simulation

The top risk factors for endodontic flare-up: a Monte Carlo simulation

What is the influence of implant surface characteristics and/or implant material on the incidence and progression of peri‐implantitis? A systematic literature review

Immediately loaded bicortical implants inserted in fresh extraction and healed sites in patients with and without a history of periodontal disease

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