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Dentists with little experience in dental implant procedures could significantly contribute to failures of the device. (DTI/Photo Ariadna de Raadt/Shutterstock)
2 Comments Nov 7, 2012 | News USA

Study suggests dentists cause implant failure

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LOMA LINDA, Calif., USA: The indications and versatility of dental implants have increased, and so have complications. Researchers from the Loma Linda University School of Dentistry in the U.S. have suggested that, regardless of patient risk factors like bruxism, successful long-term outcomes significantly depend on the experience of the clinician performing the procedure.

By reviewing the records of patients who had received full-arch maxillary and/or mandibular supported fixed complete dentures over a period of ten years, the researchers found that 12 percent of implants failed when clinicians had less than five years of experience in the field. Implants were also twice as likely to fail if the surgeon had performed less than 50 implantations in his career, they report.

Other contributors to implant failure were identified as being related to the patient rather than the implant. Almost every third patient with diabetes or a history of bruxism had experienced implant failure.

Other risk factors commonly associated with implant failure like the type of prosthesis used, smoking or implant location were found to have less impact on long-term success, according to the researchers. They stated that the absolute rate of success was found to be 90 percent.

Overall, the records of 50 patients treated with 297 implants at the school were reviewed.

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

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.

Prof. Jaime Lozada, Director, Graduate Programs, Restorative Dentistry, Oral Implant Dentistry, Loma Lima University)

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  • Val Miller, Culver City, CA, USA Apr 3, 2014 | 4:34:24 AM

    Interesting article. I have had 4 successful dental implants by two different dentists. I lost teeth nos. 3 and 4 and then 12 in the last five months. I was lured into going into a "discount dentist". Two implants were placed on my first visit, nos. 3 and 4. Within 5 weeks no. 3 was 'vibrating' in my mouth. It was subsequently removed and a bone graft placed in the socket. No. 4 (no bone graft) is hopefully to have a crown put on in six weeks. No. 12 was painful from the moment it was placed. A bone graft was done at the time of implant and the membrane fell out (along with the graft) three days later. An infection developed and after 6 weeks the implant was removed. The dentist insists that the adjacent tooth, no. 11 needed a root canal - that is why the implant failed. I have had half of a root canal finished and if I stop taking antibiotics the area becomes throbbing and painful. I really wonder since the tooth had no symptoms before r.c. if the implant didn't damage the roots of no. 11 and/or the failed bone graft caused an infection. Guess I will never know but I will have another dentist implant no. 12. This dentist wants to do another bone graft and wait a whole five months before trying another implant. I would rather not wait that long and think that another dentist could place it more exactly with something other than a one dimensional x-ray.

  • jim snell, camarillo, california Apr 18, 2013 | 10:49:48 PM

    I had a crown and tooth fail so decided to get implant plus prothesis. Implant at SUrgical Dentist went fine, like clock work - no issues. When I went in to my regular dentist I have used for a number of yeras has been extremely frustrating. First step, prothesis did not mount and seemed incorrect. Dnetist said he had been sent the wrong one. Dental mechanic who has run a lab said that was crazy and not likely. Next step, I am called in and he set about to install. It seemed very tight but they adjusted the clearances on side and top and tooth felt fine. When he put tooth in prior to last step and unglued as I was advised, he pushed it on and it made a loud click. Everything seemed correct. He next tries to remove it so he could glue it on and was unable to remove. It was decided to leave it in and If it came off; I could bring it back in and have it glued. I am warm body person and have lots of saliva = cool in my mouth. My guess is that this prothesis is clamped on the implant stud like a steel tire on a steam engine driver wheel due to interference grab. Is this normal and are tolerances so tight this action occures or is this a mistake from dental lab making prothesis. Please advise

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