Impact of local and systemic factors on the incidence of late oral implant loss

Abstract

Background: This retrospective study was set to assess the influence of systemic and local bone and intra‐oral factors on the occurrence of implant loss from abutment connection up to 2 years. Materials and methods: The files of 700 patients, have been collected randomly from the total patient group treated by means of endosseous Brånemark® system implants (Nobel Biocare, Gothenburg, Sweden) at the Department of Periodontology of the University Hospital of the Catholic University of Leuven. The end point observation was evaluating the loss of the implants 2 years after abutment installation. The study involved all implants that did not encounter early loss and implants for which it was possible to evaluate its status 2 years after abutment surgery. Thus, data of 412 patients (240 females) provided with 1514 implants were analyzed. For each patient, the medical history was carefully checked. Data collection and analysis were mainly focused on endogenous factors such as hypertension, coagulation problems, osteoporosis, hypo‐ hyperthyroidism, chemotherapy, diabetes type I or II, Crohn's disease, some local factors [e.g. bone quality and quantity, implant (length, diameter, location), type of edentulism, PTV, radiotherapy], smoking habits, and breach of sterility during surgery. Results: Radiotherapy, implant (diameter and location), and higher PTV at implant insertion and abutment connection, all affected significantly the implant loss. Conclusion: Implant location in the oral cavity and radiotherapy seem predominant to explain the occurrence of implant loss. On the other hand, smoking and systemic health factors do not seem to be prominent players in the etiology of late implant loss.

Diabetes and Oral Implant Failure

“…From the 14 studies, a total of 1,260 dental implants were inserted in diabetic patients, with 49 failures (3.89%), and 11,476 implants were inserted in non-diabetic patients, with 555 failures (4.84%). Six studies (Keller et al, 1999;Morris et al, 2000;van Steenberghe et al, 2002;Doyle et al, 2007;Bell et al, 2011;Levin et al, 2011) did not inform whether there was a statistically significant difference or not for the implant failure rates between non-diabetic and diabetic patients, whereas the other 5 studies (Accursi, 2000;Alsaadi et al, 2008b;Tawil et al, 2008;Anner et al, 2010;Le et al, 2013) did not find a statistically significant difference. One study (Alsaadi et al, 2008a) compared the implant failure rates for the non-diabetic patients with the type 1 and type 2 diabetic patients separately, with statistical and nonstatistical The study was an RCT for immediately vs. loaded implants but not for diabetic and non-diabetic patients.…”

“…Detailed data of the 14 included studies are listed in Tables 1 and 2. The meta-analysis included 7 controlled clinical trials (Morris et al, 2000;van Steenberghe et al, 2002;Dowell et al, 2007;Alsaadi et al, 2008a;Tawil et al, 2008;Levin et al, 2011;Grandi et al, 2013) and 7 retrospective analyses (Keller et al, 1999;Accursi, 2000;Doyle et al, 2007;Alsaadi et al, 2008b;Anner et al, 2010;Bell et al, 2011;Le et al, 2013). The study of Grandi et al (2013) was a randomized clinical trial for immediately vs. early loaded implants but not for diabetic vs. non-diabetic patients.…”

“…Three studies did not inform of the patients' ages (Morris et al, 2000;Alsaadi et al, 2008b;Bell et al, 2011). Four studies included only patients with diabetes type 2 (Keller et al, 1999;Morris et al, 2000;Dowell et al, 2007;Tawil et al, 2008); 5 studies included patients with type 1 and type 2 diabetes (Accursi, 2000;van Steenberghe et al, 2002;Doyle et al, 2007;Alsaadi et al, 2008a;Alsaadi et al, 2008b); and 4 studies did not offer such information (Anner et al, 2010;Bell et al, 2011;Levin et al, 2011;Le et al, 2013). Two studies (Dowell et al, 2007;Tawil et al, 2008) provided information about the patients' glycemic control through the estimation of glycosylated hemoglobin (HbA1c).…”

“…In one study (Bell et al, 2011), all implants were inserted in fresh extraction sockets, whereas another one (Le et al, 2013) inserted only short implants (≤9 mm) restored with single-unit nonsplinted restorations, and in one study (Keller et al, 1999), all implants were placed in grafted maxillary sinus or nasal floor with autologous inlay bone. Two studies (Dowell et al, 2007;Alsaadi et al, 2008a) had a follow-up to 6 mo; 6 studies had a follow-up of at least 1 yr (Keller et al, 1999;Accursi, 2000;Morris et al, 2000;Doyle et al, 2007;Alsaadi et al, 2008b;Grandi et al, 2013); 5 studies (Tawil et al, 2008;Anner et al, 2010;Bell et al, 2011;Levin et al, 2011;Le et al, 2013) had follow-ups ranging from a mean of 20 to 54 mo, whereas 1 study (van Steenberghe et al, 2002) did not inform of the follow-up period.…”

Cureent Treatment Modalities for Peri-Implant Diseases.

“…Most of the failures occurred during the first year after implant replacement. 32 Another valid alternative is to do a hybrid toothimplant-supported fixed partial denture. In a systematic review, Weber and Sukotjo have shown that, after an observation period of at least six years, implant survival and prosthetic success were similar for implant supported and tooth to implant supported prostheses.…”