Dental News - Response to Dental Tribune International article, ‘Study suggests dentists cause implant failure’

Jaime Lozada, DMD, professor, Restorative Dentistry, director, Graduate programs, Restorative Dentistry, Oral Implant Dentistry

Mon. 12 November 2012

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A brief news item in the online publication Dental Tribune International, titled “Study suggests dentists cause implant failure,” was based on a misunderstanding of an article in the Journal of Oral Implantology, Special issue, 2012, titled “Immediate Loading of Maxillary and Mandibular Implant-Supported Fixed Complete Dentures: A 1-to 10-Year Retrospective Study,” by Ting-Jen Ji, DDS, MSD, Joseph Y. K. Kan, DDS, MS, Kitichai Rungcharassaeng, DDS, MS, Phillip Roe, DDS, MS, and Jaime L. Lozada, DMD.

The Journal of Oral Implantology article, a retrospective study conducted at the Center for Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif., assessed the success rates of 50 full-arch maxillary and/or mandibular immediate loaded implant-supported fixed complete dentures, after a mean follow-up time of 42.1 months.

Variables associated with failure rates documented by Ting-Jen Ji, et al, included bone loss, type of prosthesis (provisional or definitive prosthesis), surgeons’ surgical experience (>5 years or <5 years), and the surgical site where the implants were placed.

Other studies, short- and long-term studies, involving full-arch immediately loaded maxillary and/or mandibular ISFCDs, have reported success/survival rates of 92.7 to 100.0 percent. This study showed a lower cumulative implant success rate of 85.2 percent and an absolute success rate of 90.6 percent.

The implant failure rate for two surgeons involved in the study (with >5 years of surgical experience) was 2.4 percent (two of 85 implants), whereas the remaining 18 surgeons (those with <5 years of surgical experience) incurred an implant failure rate of 12.2 percent. This particular observation can be explained by the fact that the 18 less experienced surgeons were graduate students with minimal implant surgical experience.

Also in this study, a higher implant failure rate was reported in patients with bruxism (29.3 percent) compared with patients without bruxism (4.6 percent).

Another interesting finding was that a higher implant failure rate was observed in patients with diabetes (28.6 percent) vs. patients who did not have diabetes (8.5 percent), while comparable failure rates were observed in both smokers (9.7 percent) and nonsmokers (9.4 percent).

We are looking for clarification of what our retrospective study showed: “Dentists with minimal experience placing dental implants can potentially increase the failure rate of implants placed during the immediate loading of full arch prosthesis.”

Dentists generally do not cause implant failure. But implants placed in immediate loading protocols for completely edentulous patients by inexperienced dentists experience higher failure rates.

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