Dental implant risk factors
PEARL Network risk factors JADA 2014 July
- History severe periodontitis
- Preexisting inflammation in site (endo lesion or perio lesion)
- Type IV bone
- Immediate vs delayed
- Anterior vs posterior
Risk Factors (highlight those linked to “cluster phenomenon”)
- poor bone quality or bone bone support
- untreated chronic periodontitis
- active infections
- systemic diseases (diabetes = 5-10% decrease success rate but not sure if that is untreated? Lit review says no difference Cheng 2015 JADA July)
- smoking (heavy=seen 10-15 called heavy) 2x failure rate 4x in augmented bone
- unresolved caries or infection
- advanced age (although there is research showing older age decreases risk as well Malm 2018 J Pros)
- short and/or small implants
- eccentric occlusal loading
- inadequate number implants
- parafunctional habits
- bisphosphonate discontinue oral 3 months before surgery if >3 years
- hx radiation treatment (8 years post radiation is even worse not sure why?)
- Antidepressants (doesn’t breakdown into types) Chrcanovic 2016 J Dent Res
- SSRI Wu 2014 J Dent Res Altay JOI 2018 Chrcanovic 2017 IJOMS However, SSRI increases bruxism so might just be a side effect of SSRI and not anything to do with the medication itself. Garrett 2018
- Sertaline Zoloft 60% greater risk of failure and multiple SSRI issue as well. Carr J Prostho 2019
- Proton pump inhibitors cause about a 5% increase in failure rate Chappuis 2018 COIR
- Interesting that Carr JP 2019 found no correlation of failures to any medication
- Do patients with penicillin allergy have higher rates or is it the clindamycin that is causing failures. 24% failure rate leads me to believe it must be clindamycin.
Anterior dental implant esthetic risk factors
Dental Implant Risk Factors
Failure rates of dental implants
Studies are typically showing rates from 85-95%. There is some variance in what survival and success definitions are in the literature. Lazaro-Abdulkarim JOMI 22 has a failure rate in a university setting of 5%.
Reasons for dental implant failure
Risk factors include – untreated periodontal disease, systemic disease, smoking, unresolved caries or infection, advanced age, short/small implants, inadequate number of supporting implants, parafuncitonal habits
Options Remove implant, debride site, clean CHX and/or NaCl .9% Baxter Health, graft
Cluster failure – is when multiple implants fail on the same individual risk factors of this condition are lack of bone support or quality, heavy smoker, short implants, existing periodontitis and bruxism
Dental implant bone loss risk factors
What are the patient risk factors for bone loss around dental implants from Ting 2017 Implant Dentistry systemic review?
- Periodontal disease is a major risk factor, with aggressive periodontitis being worse than chronic.
- Less bone loss in grafted sockets but more in ridge augmentation sites.
- More bone loss in smokers and in men.
- Smokers have more in the maxilla than the mandible.