Outcomes of dental implants placed in a surgical training programme

Abstract

Background: This study evaluates surgical outcomes and survival rates of implants placed in a multidisciplinary implant teaching programme. Methods: A retrospective review of all implant surgery performed over a 6-year period by accredited oral and maxillofacial surgery trainees at the Royal Dental Hospital of Melbourne was undertaken. Patients were reviewed for a minimum of 6 months post-implant placement. Implant survival was defined as those implants which were not removed, were clinically integrated as assessed by torque testing and in an appropriate position to receive a subsequent prosthesis. Kaplan-Meier analysis was used to assess overall survival and univariate factors affecting survival. Multivariate analysis used Cox proportional hazards models. Results: Over 6 years, 127 patients were treated. Follow-up data were present for 105 patients with 236 implants placed. Survival of implants at 1 and 5 years was 94 per cent and 92.8 per cent, respectively. The only univariate and multivariate factor which affected implant survival was perioperative bone grafting. All failed implants were single stage. Other factors such as patient age, smoking status, implant site, anaesthetic type, immediate or delayed placement, implant length and diameter, and medical comorbidities did not significantly affect implant survival. Conclusions: A satisfactory implant survival rate was found in a tertiary teaching centre. Perioperative bone grafting significantly increased the risk of implant failure.

Assessment of bone grafts placed within an oral and maxillofacial training programme for implant rehabilitation

“…However, there are a few studies that have assessed the outcomes of implants placed by trainees. Smith et al 1 demonstrated a good success rate of implants placed by trainees in a surgical training programme that were comparable to the literature. Melo et al 23 found similarly that there was no statistically significant difference in survival rates of implants related to different levels of training, but no such study exists in relation to bone grafting procedures.…”

“…Patients are initially referred for assessment to the implant clinic and a treatment plan derived. 1 Once patients are accepted into the implant treatment programme, those patients requiring bone grafting either prior or during implant placement are then referred to Oral and Maxillofacial Surgery.…”

“…The RDHM has day surgery facilities only and those patients with serious medical comorbidities such as significant cardiovascular or pulmonary disease, insulin dependent diabetes or patients who require overnight admission were referred to other maxillofacial units with inpatient facilities. 1 Patients were also excluded if the surgery was not primarily carried out by a surgical trainee. Accredited trainees at levels of basic and advanced surgical training performed all these procedures.…”

“…1 However, a common problem encountered is insufficient bone volume due to resorption of the alveolus. This problem can be overcome by bone grafting, which can either be performed prior to implant placement or if primary stability can be achieved, then at the time of implant placement.…”

The Development of a Composite Bone Model for Training on Placement of Dental Implants

“…The students use heads of sheep or plastic jaws made of polyurethane for training on placement of dental implants. (6,7) Polyurethane allows the building of training models with the desired characteristics of isotropy and modulus of elasticity compatible to that reported in the literature for the human jaw bones. Other models were made using artificial bone made of glass fiber reinforced composite and structural foam.…”