Retrospective Analysis of Dental Implant Failure Rates in Patients with Compromised Health

ABSTRACT

Objectives:

The goal of the current research was to compare the failure rate of dental implants in medically compromised patients to healthy individuals.

Materials and Methods:

In this seven years retrospective study, 50 patients from Group A who were medically compromised had 63 implants, while 50 patients from Group B who were healthy had 67 implants. Over 1 mm of bone loss around the implant in the first year and over 0.2 mm of bone loss per year after that were considered failure rates.

Result:

Two (2.9%) of the dental implants in Group B and 18 (28.6%) in Group A, both failed. The average bone loss around the implant in Group A during the first year was 1.21 mm, compared to 0.3 mm in Group B.

Conclusion:

Uncontrolled diabetes mellitus group had greater implant failure.

INTRODUCTION

Dental implants are becoming more and more important for replacing missing teeth. The quality of the dental implant and the supporting bone also play a role in the implant’s success rate. The success of an implant depends on the quality of the implant, including its length and type, and the quality of the bone, including its type and height. Patient factors (systemic conditions) can affect the outcome of implant treatment, including diabetes mellitus, smoking habit, bruxism, periodontal disease, bone density, hypothyroidism, bleeding disorders, xerostomia, osteoporosis, cardiovascular conditions, etc.[1,2] Deficient osseointegration, implant breakage while functioning, and infection of the peri-implant tissues that result in the loss of implant support are the causes of dental implant failure.[3]

According to follow-up studies conducted over a 10-year period, dental implants are successful in 90–95% of healthy patients.[3]

The patient’s health condition is crucial for implant placement. Therefore, the current retrospective research was conducted to assess the dental implant failure rate in patients with medical conditions.

MATERIALS AND METHODS

This retrospective study includes seven years of follow-up data. Out of the total 100 patients, 50 medically compromised patients (Group A) had 63 dental implants and 50 healthy patients (Group B as the control group) had 67 implants. This research started after obtaining consent from the institutional ethics committee. Patients with incomplete data in files and unavailable to follow up were excluded from the study.

From previous data collected over the previous seven years, all patients’ demographic information, implant duration and type, radiographic assessment of success rate, bone loss, and implant failure were noted. On the basis of clinical and radiographic conditions, an evaluation was conducted for implant stability, bone loss, infection signs, and level of bone surrounding the implant. The survival and success rates of implants were used to categorize them. According to the previously established criteria, implants were deemed unsuccessful if there was a marginal bone loss of more than 1 mm in the first year and 0.2 mm in each succeeding year. Any indications of infection close to the implant structure that led to the implant’s instability or displacement were also noted as failures.

The obtained data were statistically evaluated using the Chi-square test at a P value less than 0.05 with the SPSS package version 22.0, Inc; Chicago, IL.

RESULT

Table 1 indicated 63 dental implant placements in 50 medically compromised patients. The difference was significant (P < 0.02). The highest implants were placed in diabetic, on intra venous (IV) bisphonates treatment, and hypothyroidism cases.

Table 1.

Allocation of dental implants among participants with compromised health

Medical conditions	Number of participants (n-50)	Number of implants placed (n-63)	P
Hypothyroidism	8	10	0.032
Uncontrolled diabetes	17	21
on IV bisphonates treatment	10	11
Organ transplant	7	9
Post-radiation therapy	3	5
Xerostomia	5	7

In Group A (medically compromised), there were dental implant failures of 18 (28.6%), and there were 2 (2.9%) in Group B. (healthy patients). Mean bone loss around the implant in Group A during the first year was 1.21 mm, compared to 0.3 mm in Group B. Mean bone loss around the implant was 2.7 mm in Group A and 1.2 mm in Group B up to seven years. The distinction was determined to be significant (P = 0.05) [Table 2].

Table 2.

Failure rate in both groups

Failure	Group A (63 implants)	Group B (67 implants)	P
Number	18 (28.6%)	2 (2.9%)	0.001
Mean bone loss after one year, in mm	1.21 mm	0.3 mm	0.01
Mean bone loss after five years, in mm	2.7 mm	1.2 mm	0.02

DISCUSSION

Implant placement is difficult in patients with medical conditions. When compared to patients with compromised health, implant placement in healthy subjects is quite straight and simple. Implant dentistry may be complicated or contraindicated by an ongoing systemic disease or therapy.[4]

We discovered a higher rate of implant failure in patients with compromised health. Syed Ismail et al. discovered that diabetes patients in the medically precarious group had a higher implant failure rate.[1] Khajuria et al. and Shetty et al. came to the conclusion that patients with medical problems have higher implant failure rates than healthy patients.[4,5] Diabetes had a higher failure rate than other medically precarious conditions, according to Parihar et al.[6] These findings are in association with our result.

Retrospective research was conducted by Kandasamy et al. to evaluate implant success rates in relation to different risk factors. They come to the conclusion that a number of variables, including bruxism, diabetes, and supporting bone, can have a significant impact on the success of dental implants.[2] In contrast to our findings, Singh et al. and Santosh et al. found no alteration in the failure or success of dental implants among medically compromised patients compared to control groups.[3,7]

Conditions like cardiovascular diseases (CVD) can reduce blood flow, which can limit the amount of nutrients or oxygen that can reach the osseous tissue. There is a consequent assumption that the risk of osseointegration failure is higher.[1] Peri-implantitis, mucositis, screw fracture, and crown fracture were cited by Gupta et al. as common causes of dental implant failures.[8] The immune response of the body or the occlusal load may be the cause of early failures. The long-term effects of habits like smoking, bruxism, or fracture, however, can also contribute to late failure.[2] Additional research is required to verify the findings.

CONCLUSION

Greater success rates are seen with dental implants. However, treating conditions like hypothyroidism, diabetes, CVD, etc., can be difficult.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.