| 1. |
- Dierens, M., et al.
(författare)
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Cost estimation of single-implant treatment in the periodontally healthy patient after 16-22 years of follow-up
- 2015
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 26:11, s. 1288-1296
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Tidskriftsartikel (refereegranskat)abstract
- Background: Costs for single-implant treatment are mostly described for the initial treatment. Information on the additional cost related to aftercare is scarce. Objective: To make an estimation of complication costs of single implants in periodontally healthy patients after 16-22years and to compare costs for various prosthetic designs. Materials and methods: Patients with a single implant were recalled for a clinical examination and file investigation. Prosthetic designs included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Costs related to failures or technical, biologic, and aesthetic complications were retrieved from patient's records. Total and yearly additional complication costs were calculated as a percentage relative to the initial cost. Chair time needed to solve the complication was recorded and prosthetic designs were compared by Kruskal-Wallis tests. Results: Fifty patients with 59 surviving implants were clinically investigated. Additional complication costs after a mean follow-up of 18.5years amounted to 23% (range 0-110%) of the initial treatment cost. In total, 39% of implants presented with no costs, whereas 22% and 8% encountered additional costs over 50% and 75%, respectively. In 2%, the complication costs exceeded the initial cost. The mean yearly additional cost was 1.2% (range 0-6%) and mean complication time per implant was 67min (range 0-345min). Differences between prosthetic designs (CO, ST-PFM, ST-ACR) were statistically significant for total cost (P=0.011), yearly cost (P=0.023), and time (P=0.023). Pairwise comparison revealed significant lower costs for CO compared with ST-ACR reconstructions. Conclusion: Patients should be informed about additional costs related to complications with single implants. The mean additional cost spent on complications was almost one-quarter of the initial treatment price. A majority of implants presented with lower additional costs, whereas the highest complication costs were related to a smaller group with 22% of the implants needing more than half of the initial cost for complication management. Expenses were significantly different for various prosthetic designs.
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| 2. |
- Chrcanovic, Bruno, et al.
(författare)
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Analysis of risk factors for cluster behavior of dental implant failures
- 2017
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 19:4, s. 632-642
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSome studies indicated that implant failures are commonly concentrated in few patients. PurposeTo identify and analyze cluster behavior of dental implant failures among subjects of a retrospective study. Materials and MethodsThis retrospective study included patients receiving at least three implants only. Patients presenting at least three implant failures were classified as presenting a cluster behavior. Univariate and multivariate logistic regression models and generalized estimating equations analysis evaluated the effect of explanatory variables on the cluster behavior. ResultsThere were 1406 patients with three or more implants (8337 implants, 592 failures). Sixty-seven (4.77%) patients presented cluster behavior, with 56.8% of all implant failures. The intake of antidepressants and bruxism were identified as potential negative factors exerting a statistically significant influence on a cluster behavior at the patient-level. The negative factors at the implant-level were turned implants, short implants, poor bone quality, age of the patient, the intake of medicaments to reduce the acid gastric production, smoking, and bruxism. ConclusionsA cluster pattern among patients with implant failure is highly probable. Factors of interest as predictors for implant failures could be a number of systemic and local factors, although a direct causal relationship cannot be ascertained.
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| 3. |
- Chrcanovic, Bruno, et al.
(författare)
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Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 43:11, s. 813-823
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 130% (24/185) for bruxers and 46% (155/3364) for non-bruxers (P < 0001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3396; 95% CI 1314, 8777; P = 0012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure.
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| 4. |
- Chrcanovic, Bruno, et al.
(författare)
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Factors Influencing Early Dental Implant Failures
- 2016
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 95:9, s. 995-1002
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was to assess the influence of local and systemic factors on the occurrence of dental implant failures up to the second-stage surgery (abutment connection). This retrospective study is based on 2,670 patients who received 10,096 implants and were consecutively treated with implant-supported prostheses between 1980 and 2014 at 1 specialist clinic. Several anatomic-, patient-, health-, and implant-related factors were collected. Descriptive statistics were used to describe the patients and implants. Univariate and multivariate logistic regression models were used at the patient level as well as the implant level to evaluate the effect of explanatory variables on the failure of implants up to abutment connection. A generalized estimating equation method was used for the implant-level analysis to account for the fact that repeated observations (several implants) were available for a single patient. Overall, 642 implants (6.36%) failed, of which 176 (1.74%) in 139 patients were lost up to second-stage surgery. The distribution of implants in sites of different bone quantities and qualities was quite similar between implants lost up to and after abutment connection. Smoking and the intake of antidepressants were the statistically significant predictors in the multivariate model (ClinicalTrials. gov NCT02369562).
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| 5. |
- Chrcanovic, Bruno, et al.
(författare)
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Impact of Different Surgeons on Dental Implant Failure
- 2017
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Ingår i: International Journal of Prosthodontics. - : Quintessence Publishing. - 0893-2174 .- 1139-9791. ; 30:5, s. 445-454
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons. Materials and Methods: This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon. Results: A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival. Conclusion: Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.
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| 6. |
- Chrcanovic, Bruno, et al.
(författare)
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Intake of Proton Pump Inhibitors Is Associated with an Increased Risk of Dental Implant Failure
- 2017
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Ingår i: International Journal of Oral & Maxillofacial Implants. - : Quintessence Publishing. - 0882-2786 .- 1942-4434. ; 32:5, s. 1097-1102
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the association between the intake of proton pump inhibitors (PPIs) and the risk of dental implant failure. Materials and Methods: The present retrospective cohort study is based on patients consecutively treated between 1980 and 2014 with implant-supported/retained prostheses at one specialist clinic. Modern endosseous dental implants with cylindrical or conical design were included, and only complete cases were considered; ie, only those implants with information available for all variables measured were included in the regression model analysis. Zygomatic implants and implants detected in radiographies but without basic information about them in the patients' files were excluded from the study. Implant-and patient-related data were collected. Multilevel mixed-effects parametric survival analysis was used to test the association between PPI exposure (predictor variable) and risk of implant failure (outcome variable), adjusting for several potential confounders. Results: A total of 3,559 implants were placed in 999 patients, with 178 implants reported as failures. The implant failure rates were 12.0% (30/250) for PPI users and 4.5% (148/3,309) for nonusers. A total of 45 out of 178 (25.3%) failed implants were lost up to abutment connection (6 in PPI users, 39 in nonusers), with an early-to-late failure ratio of 0.34:1. The intake of PPIs was shown to have a statistically significant negative effect for implant survival rate (HR 2.811; 95% CI: 1.139 to 6.937; P = .025). Bruxism, smoking, implant length, prophylactic antibiotic regimen, and implant location were also identified as factors with a statistically significant effect on the implant survival rate. Conclusion: This study suggests that the intake of PPIs may be associated with an increased risk of dental implant failure.
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| 7. |
- Chrcanovic, Bruno, et al.
(författare)
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Is the intake of selective serotonin reuptake inhibitors associated with an increased risk of dental implant failure?
- 2017
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027 .- 1399-0020. ; 46:6, s. 782-788
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this retrospective study was to investigate the association between the intake of selective serotonin reuptake inhibitors (SSRIs) and the risk of dental implant failure. Patients were included if they were taking SSRIs only and no other medication, did not present any other systemic condition or compromising habits (bruxism, smoking, snuff), and complied with the use of prophylactic antibiotics for implant surgery. The multivariate generalized estimating equation (GEE) method and multilevel mixed-effects parametric survival analysis were used to test the association between SSRI exposure (predictor variable) and the risk of implant failure (outcome variable), adjusting for several potential confounders (other variables). The total number of implants with information available and meeting the necessary eligibility criteria was 931(35 failures). These were placed in 300 patients. The implant failure rate was 12.5% for SSRI users and 3.3% for nonusers (P = 0.007). Kaplan-Meier analysis showed a statistically significant difference in the cumulative survival rate (P < 0.001). The multivariate GEE model did not show a statistically significant association between SSRI intake and implant failure (P = 0.530), nor did the multilevel model (P = 0.125). It is suggested that the intake of SSRIs may not be associated with an increased risk of dental implant failure.
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| 8. |
- Gjelvold, Björn, et al.
(författare)
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Clinical and radiographic outcome following immediate loading and delayed loading of single-tooth implants: Randomized clinical trial
- 2017
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 19:3, s. 549-558
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundImmediate loading of single implants is generally considered a reliable procedure. PurposeThe objective of the present prospective randomized clinical study was to compare the overall treatment outcome following immediate loading (IL) and delayed loading (DL) of single implants after 1 year of follow-up. Materials and MethodsPatients with a missing maxillary tooth (15-25) were randomly assigned to IL or DL. The protocol included implant installation in healed sites, immediate loading, delayed loading, temporary screw-retained restoration, and replacement with a permanent single implant crown. Outcome measures were implant survival, marginal bone level, soft tissue changes, papillae index, pink, and white esthetic score (PES and WES), patient judged aesthetics, and oral health impact profile (OHiP-14). ResultsImplant survival rate was 100% and 96% for IL and DL, respectively. Implant success rate was 96% and 88% for IL and DL, respectively. Statistically significant lower papilla index scores were found in the IL group at temporary crown and definitive crown placement. An overall statistically significant improvement after 12 months for PES, WES and OHIP-14 was found. ConclusionThis prospective randomized study showed that single implants in the maxilla can present satisfactory results with respect to either immediate loading or delayed loading after 12 months.
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| 9. |
- Gjelvold, Björn, et al.
(författare)
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Esthetic and patient-centered outcomes of single implants: A retrospective study
- 2017
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Ingår i: International Journal of Oral and Maxillofacial Implants. - : Quintessence Publishing. - 0882-2786 .- 1942-4434. ; 32:5, s. 1065-1073
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aims of this clinical study were to retrospectively evaluate implant survival, patient satisfaction, and radiographic, clinical, and esthetic outcomes following single-implant treatment. Materials and Methods: Eighty-seven patients, with a total of 126 implants (XiVE S, Dentsply Implants), who received single implant-retained crowns between 2004 and 2011 were retrospectively evaluated. Implant survival, marginal bone levels (MBL), changes in implant/mesial tooth vertical relationship, pink esthetic score (PES), white esthetic score (WES), patient assessment of the esthetics (visual analog scale), and oral health impact profile (OHIP-14) were evaluated. Results: Altogether, 59 patients with a total of 85 implants attended a final clinical and radiographic follow-up examination. The mean ages of males and females at implant placement were 19.78 and 22.58 years, respectively. The mean total follow-up time from the implant surgical date was 7.51 years. The 5-year implant clinical survival rate (CSR) was 98.4% (95% CI: 96.3%-100%), and crown CSR was 91.8% (95% CI: 86.3%-97.3%). The overall mean change in MBL was -0.19 mm. No significant differences were found between the different implant diameters (3.0, 3.4, and 3.8 mm) with regard to change in MBL. Mean increase in implant infraposition was 0.13 mm. With regard to esthetics, mean initial and final total PES were 9.61 and 11.49, respectively (P < .001). The mean WES was 6.48 at follow-up. Patients' mean assessment of soft tissue esthetics and implant-supported crown appearance were 73.5 and 82.1 (maximum score 100). At the follow-up examination, the additive OHIP-14 score was 16.11. Conclusion: This retrospective study of XiVE S implants found excellent survival rates and showed good clinical outcomes concerning patient-centered findings, esthetics, and marginal bone preservation. In context, it is important to stress that this study consisted of mostly young patients with agenesis who were treated by experienced clinicians. © 2017 by Quintessence Publishing Co Inc.
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