Smoking, Radiotherapy, Diabetes and Osteoporosis as Risk Factors for Dental Implant Failure: A Meta-Analysis

Abstract

BackgroundThere are conflicting reports as to the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure. We undertook a meta-analysis to evaluate the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure.MethodsA comprehensive research on MEDLINE and EMBASE, up to January 2013, was conducted to identify potential studies. References of relevant studies were also searched. Screening, data extraction and quality assessment were conducted independently and in duplicate. A random-effects meta-analysis was used to pool estimates of relative risks (RRs) with 95% confidence intervals (CIs).ResultsA total of 51 studies were identified in this meta-analysis, with more than 40,000 dental implants placed under risk-threatening conditions. The pooled RRs showed a direct association between smoking (n = 33; RR = 1.92; 95% CI, 1.67–2.21) and radiotherapy (n = 16; RR = 2.28; 95% CI, 1.49–3.51) and the risk of dental implant failure, whereas no inverse impact of diabetes (n = 5; RR = 0.90; 95% CI, 0.62–1.32) on the risk of dental implant failure was found. The influence of osteoporosis on the risk of dental implant failure was direct but not significant (n = 4; RR = 1.09; 95% CI, 0.79–1.52). The subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size, or mean age of recruited patients.ConclusionsSmoking and radiotherapy were associated with an increased risk of dental implant failure. The relationship between diabetes and osteoporosis and the risk of implant failure warrant further study.

Risk factors for implant failure: a retrospective study in an educational institution using GEE analyses

“…However, several previous studies have demonstrated that smoking reduces the success rate of osseointegration and may be considered to be a risk factor for implant loss. 11,21 Zupnik et al could not find an association between implant failure and smoking, demonstrating a lower OR as well as a p-value of < 0.05. 19 Similarly, many studies have reported maxillary implant placement as a risk factor.…”

Dental implant survival rate in well-controlled diabetic patients. A systematic review.

“…In the last two decades, dental implants have become an increasingly popular procedure, being considered effective and predictable restorations for replacing missing teeth 1,2 . However, although the success and longterm survival of dental implants are well documented in a large number of studies 3 , failures still continue to occur for several reasons.…”

“…However, although the success and longterm survival of dental implants are well documented in a large number of studies 3 , failures still continue to occur for several reasons. Given the above, risks associated with the failure of dental implants have become a topic widely discussed in recent dental research 2 . A variety of conditions are considered influential in the outcome of the success or failure of dental implants, including: the implant design (length, shape or surface texture), medical risk factors related to the patient (systemic diseases or habits like smoking) and factors related to surgery (experience of the surgeon or surgical planning) 4,5 .…”

Risk Factors associated with Dental Implant Failure: A Study of 302 Implants placed in a Regional Center

“…The literature is divided as to whether advancing age is truly a risk factor for failure. 12,13 It has been suggested that with advancing age, there are changes in bone and collagen that may result in longer healing periods. An important note to make is that older patients may also have more alveolar bone atrophy, resulting in reduced bone volume and increasing the rate of failure.…”