Outcomes of implants and restorations placed in general dental practices

Abstract

Objectives The authors conducted a study to determine the types, outcomes, risk factors and esthetic assessment of implants and their restorations placed in the general practices of a practice-based research network. Methods All patients who visited network practices three to five years previously and underwent placement of an implant and restoration within the practice were invited to enroll. Practitioner-investigators (P-Is) recorded the status of the implant and restoration, characteristics of the implant site and restoration, presence of peri-implant pathology and an esthetic assessment by the P-I and patient. The P-Is classified implants as failures if the original implant was missing or had been replaced, the implant was mobile or elicited pain on percussion, there was overt clinical or radiographic evidence of pathology or excessive bone loss (> 0.2 millimeter per year after an initial bone loss of 2 mm). They classified restorations as failures if they had been replaced or if there was abutment or restoration fracture. Results The authors enrolled 922 implants and patients from 87 practices, with a mean (standard deviation) follow-up of 4.2 (0.6) years. Of the 920 implants for which complete data records were available, 64 (7.0 percent) were classified as failures when excessive bone loss was excluded from the analysis. When excessive bone loss was included, 172 implants (18.7 percent) were classified as failures. According to the results of univariate analysis, a history of severe periodontitis, sites with preexisting inflammation or type IV bone, cases of immediate implant placement and placement in the incisor or canine region were associated with implant failure. According to the results of multivariate analysis, sites with preexisting inflammation (odds ratio [OR] = 2.17; 95 percent confidence interval [CI], 1.41–3.34]) or type IV bone (OR = 1.99; 95 percent CI, 1.12–3.55) were associated with a greater risk of implant failure. Of the 908 surviving implants, 20 (2.2 percent) had restorations replaced or judged as needing to be replaced. The majority of P-Is and patients were satisfied with the esthetic outcomes for both the implant and restoration. Conclusions These results suggest that implant survival and success rates in general dental practices may be lower than those reported in studies conducted in academic or specialty settings. Practical Implications The results of this study, generated in the private general practice setting, add to the evidence base to facilitate implant treatment planning.

Dental implant treatment: Experience in a tertiary hospital in Nigeria

“…The age range of patients (19 years to 76 years) in this study is similar to that reported in a previous Nigerian study [2] and an Australian study [12]. The mean (standard deviation) age of the patients 50.08±13.54 years noted in this study is close to the 51.5years reported in Australia [12] but lower than the 61.4±12.2 years and 60.6±12.7 years recorded in previous studies [10,13] and higher than the 48.4±16.6 years recorded in a previous Nigerian study [2]. The most prevalent age group was 41-50years in this study, a finding different from the most prevalent age group of 60-69years reported in previous studies [12,14].…”

“…More patients are becoming aware of the use of dental implant as a form of tooth replacement therapy as a result of the unlimited information from the web and this has increased the demand for dental implants [9]. Implant therapy although accepted as a predictable treatment option for replacing missing teeth [10] is still yet to be a readily available treatment in developing economies like Nigeria. Some studies have been done in this clime as regard implant treatment of patients with good outcome [2,11] however, these studies were done majorly in the South western region, there still appears to be paucity of studies in other regions hence the need for this study which characterised the types of implants and implant supported restorations placed in a tertiary hospital in the Federal Capital Territory (FCT) of Nigeria as well as determine the outcome of the implant treatment.…”

Establishment of Epithelial Attachment on Titanium Surface Coated with Platelet Activating Peptide

“…Implants are regarded as a failure if it is removed for any reason, with clinical mobility being an absolute indication for their removal. Survival indicates that the implants are present in the oral cavity and functioning [ 1 ], with the survival rate reported to be around 95.5–97.8%. Implants in the survival category achieve success if they meet specific criteria, including a lack of biologic and/or technical complications [ 1 ], achieving an adequate amount of keratinized mucosa and soft tissue coverage, and patient satisfaction [ 2 ].…”

Surgical extrusion of a maxillary premolar after orthodontic extrusion: a retrospective study

“…Although several studies have reported high rates of survival, many surviving implants were categorized as failures (19%–64%) depending on applied success criteria29. Surgical extrusion is likely to be more cost-effective than a single-implant-supported restoration30.…”