Background: The literature indicates a reduced survival rate for dental implants placed at previously failed sites, smokers, and patients with a history of periodontal disease. The aim of this study is to review the available literature reporting on the success and/or survival of rough surface implants placed at previously failed sites, in smokers, and in periodontally compromised patients. An attempt was made to systematically review the literature and calculate an overall weighted mean survival rate for rough surface implants in each of the above three scenarios.
Methods: An electronic literature search (MEDLINE-PubMed) was performed and references hand-searched for human studies addressing the success/survival of implants placed at previously failed sites, in smokers and in patients with a history of chronic periodontal disease. The overall weighted mean survival rates and 95% confidence interval were then calculated. Results: Six retrospective studies reporting on implants placed at previously failed sites were included with total of 343 second attempts and 31 third attempts at implant placement at failed sites in 330 patients. The weighted mean survival rates for the second and third attempts at implant placement in a previously failed site were calculated to be 88.05% and 74.19%, respectively. A total of 14,395 implants were included in smoking analysis. Of these, 10,403 implants were placed in non-smokers with 250 failures and 3,992 placed in smokers, with 205 failures. The calculated overall weighted mean implant-level survival was 97.67% in non-smokers and 95.03% for in smokers. Lastly, six studies reported on 591 implants placed in periodontally compromised patients with a total of 15 failures and 198 implants placed in periodontally healthy patients with just one failure. The overall weighted mean implant survival rate was calculated to be 97.48% in periodontally compromised patients compared to 99.49% for periodontally healthy patients.
Conclusions: Of the three risk factors evaluated in this review, rough surface implants placed in previously failed sites presents the highest risk for implant failure. Rough surface implant survival declines significantly for each additional attempt at implant placement at a previously failed site, with weighted mean survival rates of 88.05% and 74.19% for the second and third attempts, respectively. Although more favorable than previously used implant designs, smokers continue to experience lower survival rates compared to non-smokers, with overall weighted mean implant survival rates of 95.03% and 97.67%, respectively. A similar finding was found for implants placed in patients with a history of chronic periodontitis. The calculated weighted mean survival rate was 99.49% for periodontally healthy patients compared to 97.48% for periodontally compromised patients.
|Advisor:||Powell, Charles A.|
|Commitee:||Astorga, Fernando, Font, Kerri, Powell, Charles A., Saunders, Madeline J.|
|School:||University of Colorado at Denver|
|Department:||Health Information Technology|
|School Location:||United States -- Colorado|
|Source:||MAI 55/06M(E), Masters Abstracts International|
|Keywords:||Dental, Failed site, History of periodontitis, Implant, Smoking, Survival|
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