A Retrospective Study Of Early Dental Implant Failure Rates And Its Risk Factors

BackgroundNowadays tooth loss is still a common disease in clinical practice,which seriously affects the patient’s aesthetic,pronunciation and chewing function.At present,movable denture repair,fixed crown and bridge repair and implant repair are three commonly used methods for clinical tooth loss repair.Implant restoration is becoming more and more popular because of its advantages such as no need to damage adjacent teeth,comfortable use,high mastication efficiency and better aesthetic effect.With the improvement of implant surface treatment technology and clinical doctor the accumulation of experience,plant repair success rate rising,but because of alveolar bone implants implanted to form effective bone combined with need over a period of time(normal 3-6 months),during this time because of the influence of various factors implants are prone to early failure.Early implant failure refers to the phenomenon that occurs when the implant is combined with the alveolar bone,and the implant loosens and falls off before the connection of the repair abutment or the implant has clinical indications that need to be removed.Ideal effective bone implant is successful,the premise of early failure is due to the implant and the alveolar bone is not enough good bone formation,but now for the implant and the alveolar bone formation causes and mechanism of effective bone combined with no unified conclusion,the same factors in the process of different research results also exist certain differences.The occurrence of early implant failure not only increases the work difficulty of clinicians,but also causes a certain psychological burden to patients.Therefore,it is of certain significance to explore the rate of early implant failure and its risk factors.According to the current situation of research on early implant failure at home and abroad,this study combined with the collection of clinical cases to retrospectively analyze the rate of early implant failure and its risk factors.ObjectiveTo study the rate of early implant failure and its related risk factors,improve the prediction of implant recovery,facilitate doctor-patient communication before implant surgery,and provide a theoretical basis for clinical reduction of early implant failure.Materials and MethodsImplantation cases were collected from associate chief physicians with more than5 years of experience in the Department of Stomatology,the First Affiliated Hospital of Guangzhou Medical University from August 2018 to December 2020.According to gender,age,cause of tooth loss,upper and lower jaw,implant position,implant timing,implant system,implant diameter,implant length,preoperative use of antibiotics,need for bone increment,type of bone increment,healing method and other related factors,the chi-square test was used for data analysis.Logistic multivariate regression analysis was applied to determine the risk factors for early dental implant failure after screening the influential factors with statistically significant differences.p< 0.05 was statistically significant for both statistical methods.ResultsA total of 1003 implant patients,including 447 male patients and 556 female patients,who were associate chief physicians in the Department of Stomatology of the First Affiliated Hospital of Guangzhou Medical University and had more than 5 years of experience in implantation,were collected from August 2018 to December 2020.A total of 1,585 implants were implanted,of which 729 were implanted in men and 856 in women.A total of 52 patients had early implant failure,and the early failure rate was 5.2%.A total of 57 implants were found to have early failure,and the early failure rate of each implant was 3.6%.1.In the early failure group and the successful group,there was no statistical significance in the distribution of age,reason of tooth loss,implant timing,implant diameter,implant length,bone cleavage,and healing method;2.The incidence of early implant failure was 5.3% in male patients and 2.1% in female patients,and the difference between the two groups was statistically significant(p<0.05).3.In general,the early failure rate of maxillary implants was 4.7%,and the early failure rate of mandibular implants was 2.6%,the difference between the two groups was statistically significant(p<0.05).Specifically,the early failure rate of implants in the mandibular anterior area was the highest(7.2%),followed by 6.3% in the maxillary molar area,6.1% in the mandibular premolar area,3.6% in the maxillary premolar area and 3.2% in the maxillary premolar area.The rate of early implant failure in mandibular molar area was 0.9%,and the difference was statistically significant(p<0.05).4.There was a statistically significant difference in the incidence of early failure among the three implant systems(p<0.05),among which the Ankylos system had the largest number of implants with the highest incidence of early failure(6.0%);5.The incidence of early implant failure was 2.2% in the group receiving antibiotics before surgery,and 4.2% in the group not receiving antibiotics before surgery,with statistical significance(p<0.05).6.The incidence of implant failure in the group requiring bone augmentation was higher than that in the group without bone augmentation,and the difference was statistically significant(p<0.05).The early implant failure rate was 13.8% in the maxillary sinus augmentation group and 2.7% in the maxillary sinus augmentation group,with statistically significant difference between the two groups(p<0.05).There was no significant difference in the early failure rate between intra maxillary sinus lift and external maxillary sinus lift.The incidence of early implant failure was6.2% in the bone graft group without collagen membrane,and 0% in the bone graft +collagen membrane group(p<0.05).7.Logistic multivariate regression analysis of multiple factors with statistical significance(gender,implant location,implant system,preoperative use of antibiotics,bone increment,maxillary sinus elevation,and bone grafting method)found that gender group and implant location group had statistical significance.The risk of early implant failure in male patients was 2.625 times that in female patients.The risk of early implant failure in the maxillary anterior area was 5.352 times that in the mandibular molar area.The risk of early implant failure in the maxillary molar area was 5.077 times that in the mandibular molar area.The risk of early implant failure in the mandibular anterior area was 7.607 times that in the mandibular molar area.The risk of early implant failure in the mandibular pregrinding area was 6.883 times that in the mandibular molar area.ConclusionIn this retrospective study,a total of 1003 patients were included in the criteria,1585 implants were implanted,and 57 implants failed early,with an early failure rate of 3.6%.The main reason for early implant failure is poor combination of implant and alveolar bone.Through chi-square test and Logistic regression analysis,gender(male)and implant location(mandibular anterior area,maxillary molar area,maxillary anterior area and mandibular premolar area)in this study were the risk factors affecting early implant failure.When the above factors exist at the same time,the choice of implant surgery should be more careful.