The failure rate associated with sinus stretch surgery is especially high and reaching. Nicolas Thiebot1*, Adel Hamdani1, Fabienne Blanchettine Dame1, Samy Tawfik1, Emery Mbapou3, Alain Ali Kaddouh1 and Alp Alantar1 Periimplantitis is a major complication and still occurs in approximately 28 to 77% of subjects, as well as in 12 to 43% of implant sites. The overall failure rate found in a recent study is around 2.1% according to Castellanos-Cosano et al. The incidence of peri-implantitis will also be compared with the results of Papaspyridakos (1.6%) and with the main risk factor recognized as preimplant surgery of the posterior maxilla in Chaware's research (4.2%).
Many failures were seen in sites rehabilitated by pre-implant bone surgery. Regarding the type of preimplant surgery, we achieved a graft failure rate (5.64%, π = 11.43%) in the paranasal sinus lift and (0.54%, α = 1.32%) in the case of GBR. The average age of patients whose implants were removed was 55.5 ± 11.5 years, consistent with studies by Lin and others. In addition, the literature shows that the most serious complications appear mainly in older individuals.
The small number of patients in the study does not allow us to draw conclusions about parity, there is no significant difference in implant loss between men and women (p = 1 OR = 0.9). Whereas in the literature, implant failures are twice as common among men. The most common complication was peri-implantitis, characterized by gingival inflammation and bone resorption. This important biological complication is the origin of an annual failure rate of 2.32% during the follow-up period of our study, and is comparable to that of Papaspyridakos et al.
The failure rate associated with sinus stretch surgery is especially high, reaching 5.64% in our study. This is consistent with a meta-analysis published by Chaware et al. They found an average failure rate associated with sinus elevation of 4.2%. The statistical analysis showed no significant differences between the studies (p = 0.2).
Our study showed a higher failure rate due to preimplant sinus stretching surgery (OR = 0.5). This confirms that other surgical techniques and preventive measures must be used to reduce the overall failure rate. An official website of the United States government They use official websites. gov A.
The gov website belongs to an official government organization of the United States. Implantation sites could play an influential role in the emergence of the FEI. Therefore, the purpose of this systematic review is to analyze high-quality studies to determine if there is a correlation between early failure and the site of implantation. Is there a correlation between the site of implantation (anterior maxilla, posterior maxilla, anterior mandibular, or posterior mandibular) and the EIF? All abstracts and full articles were reviewed and the following inclusion and exclusion criteria were applied.
The studies chosen met the criteria of retrospective, prospective and randomized clinical trials; all age groups; both sexes; all types of implants inserted in the perforated site or after using an osteotome; all patients, regardless of their smoking and the use of antibiotics. The studies that were excluded from the analysis were those of cadavers, animals, patients with systemic problems affecting bone density or mineralization, patients being treated with corticosteroids or bisphosphonates, who reported failures after prosthetic fixation, implantation in grafted sites, or after paranasal sinus lift procedures. The extracted data is shown in a table and includes the authors, the year of publication, the type of study, the site of implantation, the number of implants, the number of failed implants and the power of the study. Most of the included studies were retrospective. Randomized or blinded studies were impossible, and studies with a small sample size or an inadequate methodology were rejected.
The heterogeneity test was carried out based on heterogeneity and the degree of inconsistency of the treatment effects (I) was measured in all the trials. Heterogeneity was considered to be substantial if I2 was greater than 30% or if there was a low P value (less than 0) in the test of chi-squared to determine heterogeneity. A fixed-effects meta-analysis was used to combine the data to assume that the studies estimated the same underlying effect of the treatment. If there was sufficient clinical heterogeneity to expect the underlying effects of treatment to differ between trials, or if substantial statistical heterogeneity was detected, this situation was explored and then random effects and subgroup analyses were analyzed.
Publication bias was assessed by visually evaluating the symmetry of the funnel-shaped graphics. If asymmetry was detected, we performed exploratory analyses to investigate it. The dichotomous analysis in the form of the number of failed implants in proportion to the total number of implants inserted was analyzed with a risk ratio (RR) (relative risk) and a 95% confidence interval (CI) for each study. Random effects were selected when comparing the failures of maxillary and mandibular implants due to heterogeneity.
The subgroup analysis of the anterior and posterior sites of both bones was performed with a fixed effect and a 95% confidence interval for accurate results. The risk difference (RD) (absolute risk) was used to state the results and draw conclusions. After searching the electronic databases, 341 publications were identified; 17 more articles were added after a manual search (35 in total). The elimination of duplicates (120 studies) left 238 studies, studies that did not meet the inclusion criteria were rejected (136 studies), and the remaining 102 studies were submitted for reading the full text.
Among them, 74 studies were excluded due to lack of data, 7 studies had a methodological bias and a final total of 21 studies4,10,14,15,20-36 were included in this review. The analysis of the 21 included studies included a total of 78,230 implants, including 39,468 implants in the upper jaw bone and 38,762 implants placed in the lower jaw bone. A total of 1239 implants failed in the upper jaw (3.14%) and 759 in the lower jaw (1.96%). Comparison of the anterior maxillary region with the anterior mandibular region Data were extracted from 11 studies4,14,21,23,26-28,30-32.34 with a total of 14,516 implants.
Of these implants, 8,389 were placed in the maxillary aesthetic area and 6,127 implants were placed in the lower anterior region of the mandible. There were a total of 522 failed implants in the anterior maxillary region (6.2%), compared to 153 failed implants in the anterior mandibular region (2.5%). The RD analysis showed a 3% increase in the risk of failure in the anterior maxillary region compared to the mandibular region previous. Comparison of the posterior maxillary region with the posterior mandibular region Data were extracted from 13 studies4,14,21-24,26,28,30-34 with a total of 39,014 implants; of these, 17,472 were inserted in the maxillary posterior region and 21,542 in the lower posterior region of the mandible.
There were a total of 338 failed implants in the posterior maxillary region (1.9%), compared to 314 failed implants in the posterior mandibular region (1.46%). The RD analysis showed the same risk in the posterior maxillary region as in the posterior mandibular region. Comparison of the anterior maxillary region with the posterior maxillary region A total of 498 implants failed in the anterior region (4%), compared to 333 in the posterior region (2.19%)). The RD analysis reported the same risk of failure in the anterior and posterior maxillary regions.
Comparison of the anterior mandibular region with the posterior mandibular region A total of 168 implants failed in the anterior region (2.5%), compared to 262 implants that failed in the posterior region (4.2%). The RD analysis showed a 2% higher risk of failure in the posterior mandibular region than in the anterior region. Comparison of the anterior maxillary region with the posterior mandibular region Data were extracted from 11 studies4,21-24,26,28,31-34 with a total of 29,800 implants, of which 10,598 were inserted in the region anterior maxillary and 19,202 were placed in the posterior mandibular region. A total of 292 implants failed in the anterior maxillary region (2.8%) compared to 270 failed implants in the posterior mandibular region (1.4%).
The RD analysis showed the same risk in the anterior maxillary and posterior mandibular regions. Comparison of the anterior mandibular region with the posterior maxillary region Data were extracted from 12 studies4,14,21-24,26-28,31,32,34 with a total of 14,984 implants, of which 7,500 were inserted in the anterior mandibular region and 7,484 in the posterior maxillary region. A total of 184 implants failed in the anterior region of the mandible (2.5%), compared to 356 failed implants in the posterior region of the jaw (4.8%).The RD analysis reported a 3% higher risk of failure in the posterior maxillary region compared to the anterior mandibular region. Funnel-shaped graphics were used to visually assess publication bias.
The EIF depends on the surgeon's skill, the type and site of the implant, the condition of the bone, and the circumstances during the healing process. The main objective of this review was to explore any association between the implant site and the FEI by comparing studies performed with implants inserted in different regions of the upper and lower jaw to determine which site most influenced early implant failure and to change the practice of using a single implant design for all anatomical regions. EIFs occur due to the formation of fibrous tissue before osseointegration or to the micro-movements of implants during healing. EIFs are related to bone quality, implant design, bacterial invasion, or inadequate site preparation, which impedes the osseointegration process.
In the current review, studies of a total of 78,230 dental implants were analyzed in which failures were registered after their insertion in different anatomical regions using a fixed effects model. The studies were unable to determine all the confounding factors that could cause the onset of the EIFs. In this review, an attempt was made to exclude studies with implants placed in sites immediately after extraction, based on the results of Quirynen et al. 37, who related the pathology of the extracted tooth to the early failure of the inserted implant.
In addition, studies that included implants inserted after paranasal sinus elevation or bone expansion due to the presence of multiple confounding factors were excluded from the analysis. The results of the current review confirmed that the failure rate of maxillary implants was significantly higher than that of mandibular implants, and that implants placed in the jaw produce twice as many failures as those in the jaw. This review examined the role of the implant site as a risk factor responsible for early implant loss. in both jaw bones.
A RD of 1% was detected between the upper and lower jaws. Posterior implants in both arches have also shown significant flaws compared to anterior mandibular implants. Limiting the risk of failure to the insertion site is unfair, but it helps to improve implant design and surgical techniques, which can be modified depending on the insertion site. Retrospective studies may carry the risk of missing data and that the results will not be correctly interpreted.
Reducing the inclusion criteria increases homogeneity between studies, but could result in the exclusion of some trials with valuable data. The percentage of EIF is high compared to that of failures after charging. In this review, a single main factor was identified for these failures, and the author recommends carrying out more evaluations of the site of implantation taking into account other risk factors. It is recommended to build variable implant designs according to the bone quality of each anatomical site.
Implants designed for high-risk regions should differ in design and surface characteristics compared to those inserted in regions with a low failure rate. Implants that rely on bone compression to increase primary stability are not suitable in areas with dense bones. Finally, it is suggested to place recently modified implants in the form of nanotopographic surface treatments, with high surface wettability and growth factors in high-risk areas, such as the anterior maxillary region, depending on the cost-benefit ratio. The anterior maxilla is a critical site for EIFs compared to other alveolar sites.
Implants inserted into the anterior jaw showed the best success rate compared to other alveolar bone sites. The maxilla is riskier than the mandible when it comes to EIFs, but the difference between the posterior maxillary and posterior mandibular regions is not significant. Abdominal dystrophy between the maxilla and mandible is related to the high-risk anterior maxillary region. The author wishes to thank Prof.
Ghada El Shazly for his help in this review by verifying the inclusion and exclusion of studies. He participated in the study design, data collection and statistical analysis of the results and wrote the manuscript. Here you will find articles from the journal of the Korean Association of Oral and Maxillofacial Surgeons, courtesy of the National Library of Medicine of the Korean Association of Oral and Maxillofacial Surgeons, 8600 Rockville Pike Bethesda, MD 20894. The early failure rate was 66% and the late failure rate was 34% for failed implants. The reasons for the failure of 91 implants were analyzed separately to determine early and late failures (table).
Most of the early failures had an unspecified cause (35%). Inflammation and infection accounted for 32% and 22%, respectively, of the first failures. Other causes included iatrogenic problems (poor position and nerve damage) and joint problems. The causes of late failures included biological problems (e.g.The other causes of late failures included unspecified reasons, overloads, infections, and device problems.
The objective of the systematic review and meta-analysis was to evaluate implant failure rates and their association with guided and freehand implant placement techniques. Both guided and free-handed implant placement techniques resulted in a high implant survival rate. However, implant failure rates were nearly three times higher in the freehand implant placement category. A guided implant placement approach is recommended for a successful outcome. Prosthodontic rehabilitation with dental implants requires precise implant placement for predictable functional and aesthetic results.
1,2 Implantology has developed numerous advances in technology, materials, techniques and concepts to achieve the desired beneficial clinical outcomes. 3 The risk of bias assessment for included RCTs and cohort studies was conducted following the guidelines of the Cochrane Systematic Review Manual, 39,40 JBI Critical Appraisal Checklist for Quasi-Experimental Studies for no randomized and randomized zoned experimental studies were used, 41 The data extraction process was executed in duplicate and independently by two authors. Then, two authors double-checked it to validate the information collected. Any disagreement was resolved through discussion or consultation with the third author.
The meta-analysis was carried out with RevMan 5.3, building a forest plot with I2 statistics to analyze and present the variability due to the heterogeneity between the studies collected. The relative weights of the included studies were expressed in percentages and the risk ratio (RR) was calculated with a confidence interval (CI) of 95% per study or subgroup. The number of records identified during the initial search represents the sum of all the items collected in each electronic database. The fully guided technique has the advantage of precision in the placement of implants compared to the freehand technique.
Precise implant placement ensures a predictable restorative result. A disadvantage of a fully guided approach is that it involves additional cost and, in cases of limited mouth opening, following a fully guided drilling sequence can be difficult. 48 In addition, few studies have reported that guided surgeries can easily cause operator supervision during osteotomy preparation and cause inadequate irrigation during surgery, 48 This could interfere with bone healing and compromise the outcome, 6,48 However, the finding of this systematic review was contrary to the suggested result. In addition, some studies compared intraoperative and postoperative complications and morbidity after implant placement 46,47. Unlike other studies, the present study reported a reduction in postoperative morbidity in terms of swelling, pain and bleeding with guided implant placement compared to the freehand approach, 4,43 Proper case selection and surgical execution could contribute to these differences.
Within the limitations of this systematic review, both guided and manual implant placement have a high survival rate. However, according to the results, implant failure rates were almost three times higher in freehand placement. Article PubMed Google Scholar Google Scholar Article PubMed Central Google Scholar PubMed Google Scholar School of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, College of Dentistry Canada, University of Alexandria, Alexandria, Egypt Postgraduate degree in Prosthodontics, Marquette University School of Dentistry, Milwaukee, WI, USA. UU.
School of Medicine and Dentistry, Division of Periodontology, University of Alberta, Edmonton, AB, Canada MPG and SP conceived from the idea presented. MPG developed the theory and performed the calculations. NA investigated the research question, carried out the analysis of the data and wrote the manuscript with the support and supervision of MPG and SP. All authors provided critical comments and helped to shape the research, analysis, and manuscript.
Correspondence to Monica Prasad Gibson. The authors declare that they have no competing interests. Provided by the Springer Nature Sharedit content sharing initiative, Oral and Maxillofacial Surgery (202). Other factors collected were the time of failure (early or late failure), the time of reimplantation (immediate, early or late), the change of device between the first implant and the second implant (design, diameter and length) and the details of the prosthesis (single or with splint, bridge, cement or screw).Causes of early implant failure include excessive heating of the bone during drilling, excessive preparation of the surgical site, or low bone density that interferes with the primary stability of the implant.
Electronic and manual search for studies in which an early failure of dental implants has been detected, based on the place of collection. The purpose of this study was to evaluate failed implants and replantation survival and to identify relative risk factors for implants to fail again. Bone type influences EEI rates; however, some studies included implants inserted into poor quality bone without affecting the implant success rate23,45. The treating doctor performed the dental care and the periodontal treatment before implant surgery. Multiple etiological factors contribute to implant failure, which can be divided into early and late depending on when the implant is lost.
Five studies4,43,45,46,47 identified implant failure in relation to guided or freehand placement of the implant. The multivariate analysis of this model included age at the time of reimplantation, HTN, DM, taking an antithrombotic agent, smoking, a bone graft at the time of initial implantation, the site of implantation (maxillary or mandible), the time of initial implantation failure (early or late), and bone grafting at the time of reimplantation, which were considered to be highly relevant. Several studies have attempted to compare implant failure rates with respect to the region where the implant is inserted into the jaw. During the search process, several combinations of keywords, such as guided, unguided, freehand, three-dimensional dental implants, peri-implantitis and risk factors, were used to generate records related to implant failure and the use of surgical guides.
