J Periodontal Implant Sci.  2014 Jun;44(3):102-108. 10.5051/jpis.2014.44.3.102.

Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis

• Busenlechner D
• Furhauser
• Haas R
• Watzek G
• Mailath G
• Pommer B

• KMID: 2012984
• DOI: http://doi.org/10.5051/jpis.2014.44.3.102

Abstract

PURPOSE
Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success.
METHODS
From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed.
RESULTS
Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P<0.001) and a positive history of periodontal disease doubled the failure risk (P=0.001).
CONCLUSIONS
Summing up the long-term results of well over 10,000 implants at the Academy for Oral Implantology in Vienna it can be concluded that there is only a limited number of patients that do not qualify for implant therapy and may thus not benefit from improved quality of life associated with fixed implant-retained prostheses.

Keyword

Dental implants; Endosseous dental implantation; Implant-supported dental prosthesis; Periodontal diseases; Risk factors; Survival analysis

MeSH Terms

Dental Implantation, Endosseous
Dental Implants
Dental Prosthesis, Implant-Supported
Dentition
Diabetes Mellitus
Follow-Up Studies*
Humans
Jaw
Osteoporosis
Periodontal Diseases
Prostheses and Implants
Quality of Life
Rehabilitation
Risk Factors*
Smoke
Smoking
Survival Analysis
Survival Rate
Dental Implants
Smoke

Figure

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  Figure 1 The number of dental implants placed at the Academy for Oral Implantology increased significantly in the years 2004 to 2012 (over 2000 implants per year) while the failure rate remained stable at around 3%.

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  Figure 2 Implant rehabilitation of the completely edentulous maxilla according to the All-on-4 (Nobel Biocare, Gothenburg, Sweden) flapless protocol. (A) Preoperative planning procedure using cone-beam computed tomographic scans, (B) postoperative x-ray with impression copings and angulated multiunit abutments on tilted distal implants, (C) immediate temporary fixed restoration delivered at the day of surgery, (D) pictures and x-rays at final prosthesis delivery, and (E, F) 5 years after implant placement.

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  Figure 3 The number of grafting procedures to enhance bone volume for implant insertion (total of 1,917 sinus floor elevation operations, horizontal or vertical block augmentations, and socket grafts).

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  Figure 4 Kaplan-Meier curves (and 95% confidence intervals) for implant survival through 96 months (8 years) in healthy patients (A), smokers (B), and patients suffering periodontal disease (C).

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