The Survival Rate And Risk Factors Of Implants In The Early Stage:A Retrospective Study

Objective:To analyze the early survival and failure rate of 2053 implants implanted in the General Hospital of the Southern Theater(formerly Guangzhou Military Region)from 2006 to 2017 Simultaneously,the causes and risk factors of early failure of implants were explored to provide some experience and guidance for future dental implant treatment clinicallyMethods:1078 cases of tooth loss patients and 2053 implants were enrolled in this study from the General Hospital of the Southern Theater from 2006 to 2017,including 601 males and 477 females,aged 18～92 years with an average of 48.2.The early survival rate of implants was calculated individually.All implants were grouped into two or more categories by diverse variates gender,age,maxillary/mandibular,tooth position,bone mass and bone density,bone augmentation,bone augmentation categories,immediate implantation,embedded type of implant,operator,implant experience,implant types,diameter,length,implant torque,Statistical analysis was performed using SPSS 22.0,and the continuous variables were expressed by mean and variance,the categorical variables was analyzed by chi-square test.Due to exist many factors affecting implant failure in this study,the chi-square test was used as univariate analysis,and the seven significant factors were constructed into the multi-logistical regression model to identify the independent risk factors of implant failure(P<0.05)Results:1.The early survival rate of 2053 implants was 96.15%,and the failure rate was 3.85%.Most of the early failures occurred before the restoration(4 months after surgery)result from unsuccess of osseointegration secondary to wound dehiscence and infection,bone thermal injury,excessive implant torque,perforation of the fossa sidewall,early weight bearing,and uncontrolled periodontal inflammation2.The results of chi-square test:a total of 2053 implants were studied:Age:241 under 30 years old,8 failed,the survival rate was 96.68%;1367 in 30～60 years old,62 failed,the survival rate was 95.46%;445 were 60 years old and above,9 failures and the survival rate was 97.98%(P=0.040).Types of bone bass and density:110 of type Ⅰ,with 10 failures and a survival rate of 90.90%;1788 of type Ⅱ～Ⅲ,65 failures,and a survival rate of 96.36%;155 of type IV,4 failures,and a survival rate of 97.41%(P=0.018).Selection of bone augmentation:525 were applied,34 failed,and the survival rate was 93.85%;1528 were not adopted,45 failures,and the survival rate was 97.05%(P=0.000).Timing of implant:14 of 95 fail to therapy in group of immediate implant and the survival rate was 85.26%;65 of 1958 were unsuccessful in group of delayed implant and the survival rate was 96.68%(P=0.040).Stage of implant:in stage I implants,822 implants were implanted,47 failed,and survival rate was 94.28%;1231 were not buried,32 were failed,and the survival rate was 97.40%(P=0.040).Implant length:261 of<10mm group,21 failure,survival rate 91.95%;1600 of 10～13mm group,46 failure,survival rate 97.13%;192 of≥13mm group,12 failure,survival rate 93.75%(P=0.000).Tooth position there were 345 anterior teeth,23 failed,the survival rate was 93.33%;461 premolars,22 failed,the survival rate was 95.23%;1247 molars,34 failures,the survival rate was 97.27%(P=0.002)3.No statistical significance of the early survival rate of implants in set of gender,maxillary/mandibular,bone augmentation categories,operator,implant experience,implant types,diameter and implant torque(P>0.05)4.Multiple logistic regression results:age(30～60 years)(OR=2.392),bone mass(OR=3.689),bone augmentation surgery(OR=1.742),immediate implantation(OR=3.509),implant The first phase of surgery was buried(OR=1.855)and implant length(OR=2.972)are risk factors for early failure in implantConclusions:1.The early survival rate of implants(1 year post-implant and pre-restoration)exceeded 96%,and 87.34%of the 79 failed implants occurred,which could attributed to the failure of osseointegration with the factors of wound dehiscence and infection,bone thermal injury,excessive implant torque,perforation of the fossa sidewall,early weight bearing,and uncontrolled periodontal inflammation2.Age(30～60),tooth position(anterior teeth area),bone mass and density(Class Ⅰ),implant length(<10mm),bone incremental surgery,and immediate implant are risk factors which could affect the early survival rate of the implant.Notably,when the above factors coexist,we should select the scheme of implant thoughtfully3..A length of≥10mm implant can be selected as much as possible for the acceptable condition of local bone.