Journal List > J Korean Acad Prosthodont > v.48(1) > 1034636

Kim, Kim, Lee, and Han: The effects of local factors on the survival of dental implants: A 19 year retrospective study

Abstract

Purpose

The aim of this retrospective study was to provide long-term data about the correlation between multifactorial local factors and the survival of implants.

Material and methods

During 19 years (1991 to 2009), 2796 implants were placed in 879 patients. From dental charts and radiographs, the following data were collected: patient's age at implant placement, gender, implant system, surface, length, diameter, location of implant placement, bone quality, primary stability, type of prosthesis. The correlations between these data and implant survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival analysis, Chi-square test, odds ratio.

Results

1. Among the 2796 implants, 150 implants failed that resulted in a cumulative survival rate of 94.64%. The cumulative survival rate of smooth surface implants (91.76%) was lower than rough surface implants (96.02%). 2. Anatomic location, implant surface, diameter of smooth surface implant, primary stability, type of prosthesis, patient's age and gender were significantly associated with implant survival (P < .05). 3. No significant difference in implant survival was found in relation to the following factors: implant length, bone quality, diameter of rough surface implants and type of rough surface according to implant manufacturer (P < .05).

Conclusions

Local factors such as anatomic location, implant surface, diameter of smooth surface implant, primary stability and type of prosthesis have a significant effect on implant survival. (J Korean Acad Prosthodont 2010;48:28-40)

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Fig. 1.
The distributions of the placed implants according to patients’ age and gender.
jkap-48-28f1.tif
Fig. 2.
Distribution of the placed implants according to implant company and surface.
jkap-48-28f2.tif
Fig. 3.
Distribution of the placed implants according to location and implant surface.
jkap-48-28f3.tif
Fig. 4.
Distribution of the placed implants according to implant length and surface.
jkap-48-28f4.tif
Fig. 5.
Distribution of the placed implants according to implant diameter and surface.
jkap-48-28f5.tif
Fig. 6.
Distribution of the placed implants according to type of prosthesis.
jkap-48-28f6.tif
Fig. 7.
Kaplan- Meier curves for implant survival, by type of implant surface.
jkap-48-28f7.tif
Fig. 8.
Kaplan- Meier curves for implant survival, by type of implant company and surface.
jkap-48-28f8.tif
Table I.
The distribution of the placed implants according to location and bone type
  Smooth surface n (%) Rough surface n (%) Total n (%)
Location
Ant. Mx. 152 (16.70) 220 (11.66) 372 (13.30)
Post. Mx. 233 (25.60) 638 (33.83) 871 (31.15)
Ant. Mn. 63 (6.92) 80 (4.24) 143 (5.12)
Post. Mx. 462 (50.77) 948 (50.27) 1410 (50.43)
Bone type
Type I 28 (3.08) 45 (2.39) 73 (2.61)
Type II 67 (7.36) 1130 (59.92) 1197 (42.81)
Type III 62 (6.81) 326 (17.29) 388 (13.88)
Type IV 41 (4.51) 47 (2.49) 88 (3.15)
Unknown 712 (78.24) 38 (17.92) 1050 (37.55)
Total 910 (100) 1886 (100) 2796 (100)

Ant.: anterior; Post.: posterior; Mx.: maxilla; Mn.: mandible

Table II.
The distribution of the placed implants according to implant diameter and length
  Smooth surface n (%) Rough surface n (%) Total n (%)
Length (mm)
< 10 86 (9.45) 185 (9.81) 271 (9.69)
10 - 15 787 (86.48) 1679 (89.02) 2466 (88.20)
> 15 37 (4.07) 22 (1.17) 59 (2.11)
Diameter (mm)
< 3.75 17 (1.87) 95 (5.04) 112 (4.00)
3.75 - 4.5 709 (77.91) 943 (50.00) 1652 (59.09)
> 4.5 184 (20.22) 848 (44.96) 1032 (36.91)
Total 910 (100) 1886 (100) 2796 (100)
Table III.
The distribution of the placed implants according to primary stability
  Smooth surface n (%) Rough surface n (%) Total n (%)
Excellent 36 (3.96) 668 (35.42) 704 (25.18)
Good 44 (4.84) 467 (24.76) 511 (18.28)
Fair 11 (1.21) 182 (9.65) 193 (6.90)
Poor 15 (1.65) 23 (1.22) 38 (1.36)
Unknown 804 (88.35) 546 (28.95) 1350 (48.28)
Total 910 (100) 1886 (100) 2796 (100)
Table IV.
The distribution of the placed implants according to type of prosthesis
  Smooth surface n (%) Rough surface n (%) Total n (%)
Single crown 105 (11.99) 364 (19.85) 469 (17.31)
FPD 677 (77.28) 1289 (70.28) 1966 (72.55)
Overdenture 87 (9.93) 170 (9.27) 257 (9.48)
Telescopic denture 7 (0.80) 11 (0.60) 18 (0.66)
Total 876 (100) 1834 (100) 2710 (100)
Table V.
Timing of implant failure according to implant surface
  Smooth surface (% row) (% column) Rough surface (% row (% column) w) Total (% row) (% column)
Early failure 34 (39.53) 52 (60.47) 86 (100)
  (45.33) (69.33) (57.33)
Late failure 41 (64.06) 23 (35.94) 64 (100)
  (54.67) (30.67%) (42.67)
Total 75 (50) 75 (50) 150
  (100) (100)  
Table VI.
Survival rate according to patient related factor (age, gender)
  Placed implant (n) Failed Implant (n) CSR (%) P - value Odds ratio 95% CI
Total 2796 150 94.64      
Age
< 40 532 12 97.74 0.001 1.00 1.00a,b
40 - 59 1373 78 94.32   2.6 1.41, 4.83a
60 - 79 855 59 93.10   3.21 1.71, 6.03b
> 79 36 1 97.22   1.24 0.16, 9.80
Gender
Male 1431 91 93.64 0.0188 1.00 1.00c
Female 1365 59 95.68   0.67 0.48, 0.93c

CSR: cumulative survival rate Groups with same superscripts are significantly different at P < .05.

Table VII.
Survival rate according to implant surface and company
Placed implant (n) Failed CSR (%) P- value Odds ratio 95% CI
Implant (n)
Total 2796 150 94.64      
Surface
Smooth 910 75 91.76 0.0039 1.00 1.00a
Rough 1886 75 96.02   0.46 0.33, 0.64a
Company, surface
Brarnemark® 910 machined 75 91.76 <.0001 1.00 1.00b,c
Brarnemark® 246 Ti-Unite 7 97.15   0.33 0.15, 0.72b
ITI®, SLA 864 23 97.33   0.30 0.19, 0.49
ITI®, TPS 24 1 95.83   0.48 0.06, 3.63
Replace® 28 Ti-Unite 2 92.86   0.86 0.20, 3.68
Replace® 24 acid etched 3 87.50   1.59 0.46, 5.46
Silhouette® 693 RBM 37 94.66   0.63 0.42, 0.94
Etc. 6 2 66.67   5.57 1.00, 30.8c

Groups with same superscripts are significantly different at P < .05.

Table VIII.
Survival rate according to implant surface and location
  Placed implant (n) Failed Implant (n) CSR (%) P- value Odds ratio 95% CI
Total 2796 150 94.64      
Ant. Mx. 372 24 93.55 <.0001 1.00 1.00a
Post. Mx. 871 77 91.16 1.41 0.87, 2.26b,c
Ant. Mn. 143 1 99.30 0.10 0.01, 0.76a,b
Post. Mn. 1410 48 96.60 0.51 0.31, 0.85c
Smooth surface 910 75 91.76    
Ant. Mx. 153 11 92.81 0.0042 1.00 1.00
Post. Mx. 218 31 85.78 2.14 1.04, 4.40d,e
Ant. Mn. 64 1 98.44 0.20 0.03, 1.62d
Post. Mn. 475 32 93.26 0.93 0.46, 1.90e
Rough surface 1886 75 96.02    
Ant. Mx. 219 13 94.06 < .0001 1.00 1.00f
Post. Mx. 653 46 92.96 1.20 0.63, 2.27g
Ant. Mn. 79 0 100.00 0.94 0.91, 0.97
Post. Mn. 935 16 98.29 0.28 0.13, 0.58f.g

Ant., anterior; Post., posterior; Mx, maxilla; Mn., mandible. Groups with same superscripts are significantly different at P < .05.

Table IX.
Survival rate according to implant surface and length
  Placed implant (n) Failed Implant (n) CSR (%) P- value Odds ratio 95% CI
Total 2796 150 94.64      
< 10 271 19 92.99 0.2447 1.00 1.00
10 - 15 2466 125 94.93 0.71 0.43, 1.17
> 15 59 6 89.83 1.50 0.57, 3.93
Smooth surface 910 75 91.76    
< 10 83 7 91.57 0.8494 1.00 1.00
10 - 15 781 63 91.93 0.95 0.42, 2.15
> 15 46 5 89.13 1.30 0.40, 4.44
Rough surface 1886 75 96.02    
< 10 188 12 93.62 0.1984 1.00 1.00
10 - 15 1685 62 96.32 0.56 0.30, 1.06
> 15 13 1 92.31 1.22 0.15, 10.20

There are no significant differences between the implant length and the survival rate. Therefore, the odds ratio is not available.

Table X.
Survival rate according to implant surface and diameter
  Placed implant (n) Failed Implant (n) CSR (%) P- value Odds ratio 95% CI
Total 2796 150 94.64      
< 3.75 112 1 99.11 0.041 1.00 1.00
3.75 - 4.5 1652 86 94.79 6.10 0.84, 44.18
> 4.5 1032 63 93.90 7.22 0.99, 52.54
Smooth surface 910 75 91.76    
< 3.75 14 0 100.00 0.0079 1.00 1.00a
3.75 - 4.5 737 52 92.94 1.08 1.05, 1.10a
> 4.5 159 23 85.53 1.17 1.10, 1.25
Rough surface 1886 75 96.02    
< 3.75 98 1 98.98 0.2011 1.00 1.00
3.75 - 4.5 915 34 96.28 3.74 0.51, 27.65
> 4.5 873 40 95.42 4.66 0.63,34.26

Groups with same superscripts are significantly different at P < .05.

Table XI.
Survival rate according to implant surface and bone quality
  Placed implant (n) Failed Implant (n) CSR (%) P - value Odds ratio 95% CI
Total 2796 150 94.64      
Type I 73 2 97.26 0.144 1.00 1.00
Type II 1197 52 95.66 1.61 0.38, 6.75
Type III 388 25 93.56 2.44 0.57, 10.55
Type IV 88 9 89.77 4.04 0.85, 19.35
Unknown 1050 62 94.64 - - -
Smooth s. 910 75 91.76      
Type I 28 1 96.43 0.4744 1.00 1.00
Type II 67 5 92.54 2.18 0.24, 19.54
Type III 62 8 87.10 4 0.48, 33.64
Type IV 41 5 87.80 3.75 0.41, 33.99
Unknown 712 56 92.13 - - -
Rough s. 1886 75 96.02      
Type I 45 1 97.78 0.4181 1.00 1.00
Type II 1130 47 95.84 1.91 0.26, 14.16
Type III 326 17 94.79 2.42 0.31, 18.64
Type IV 47 4 91.49 4.093 0.44, 38.11
Unknown 338 6 98.23 - - -

There are no significant differences between the bone quality and the survival rate. Therefore, the odds ratio is not available. Smooth s., smooth surface; Rough s., rough surface.

Table XII.
Survival rate according to implant surface and primary stability
  Placed implant (n) Failed Implant (n) CSR (%) P- value Odds ratio 95% CI
Total 2796 150 94.64      
Excellent 704 27 96.16 < .0001 1.00 1.00a,b,c
Good 511 20 96.09   1.02 0.57, 1.84d,e
Fair 193 20 89.64   2.90 1.59, 5.29b,d,f
Poor 38 11 71.05   10.22 4.59, 22.73c,e,f
Unknown 1350 72 94.67 - - -
Smooth s. 910 75 91.76      
Excellent 36 2 94.44 0.0187 1.00 1.00
Good 44 3 93.18   1.24 0.20, 7.88g
Fair 11 1 90.91   1.70 0.14, 20.75
Poor 15 5 66.67   8.50 1.43, 50.66g
Unknown 804 64 92.04 - - -
Rough s. 1886 75 96.02      
Excellent 668 25 96.26 <.0001 1.00 1.00h,i
Good 467 17 96.36   0.97 0.52, 1.82j,k
Fair 182 19 89.56   3.00 1.61, 5.5h,j
Poor 23 6 73.91   9.08 3.30, 24.99i,k
Unknown 546 8 98.53 - - -

Smooth s.: smooth surface; Rough s.: rough surface Groups with same superscripts are significantly different at P < .05.

Table XIII.
Survival rate according to implant surface and type of prosthesis
  Placed implant (n) Failed Implant (n) CSR (%) P- value Odds ratio 95% CI
Total 2796 150 94.64      
SC 469 13 97.23 < .0001 1.00 1.00a
FPD 1966 30 98.47 0.62 0.32, 1.18b
OD 257 13 94.94 2.03 0.94, 4.39c
TD 18 8 55.56 31.57 10.98, 90.75a,b,c
Smooth s. 910 75 91.76    
SC 105 6 94.28 < .0001 1.00 1.00d
FPD 677 22 96.75 0.55 0.22, 1.40e
OD 87 8 90.80 1.67 0.56, 5.01f
TD 7 5 28.57 49.5 8.18, 299.46d,e,f
Rough s. 1886 75 96.02    
SC 364 7 98.08 <.0001 1.00 1.00g
FPD 1289 8 99.38 0.48 0.19, 1.22h
OD 170 5 97.06 1.88 0.62, 5.67i
TD 11 3 72.73 19.13 4.17, 87.72g,h,i

Groups with same superscripts are significantly different at P < .05. SC, implant supported single crown; OD, overdenture; FPD, implant supported fixed partial denture; TD, telescopic denture; Smooth s., smooth surface; Rough s., rough surface.

Table XIV.
Survival rate according to implant surface and type of overdenture
  Placed implant (n) Failed Implant (n) CSR t (%) P- value Odds ratio 95% CI
Total 257 13 94.94      
SO 192 2 98.96 0.0024 1.00 1.00a
RO 65 11 83.08 5.1930 1.63, 16.50a
Smooth surface e 87 8 90.8    
SO 47 2 95.74 0.0156 1.00 1.00b
RO 40 6 85.00 3.9706 0.75, 20.91b
Rough surface 170 5 97.06    
SO 145 0 100.00 0.0598 1.00 1.00
RO 25 5 80.00 4.0580 0.64, 25.62

Groups with same superscripts are significantly different at P < .05. SO: implant supported overdenture; RO: implant retained overdenture

Table XV.
Survival rate according to type of prosthesis, implant surface and location
Type of Prosthesis Implant surface Location
Maxilla Mandible
Placed (n) Failed (n) CSR (%) Placed (n) Failed (n) CSR (%)
Single crown Machined Rough 61 170 2 5 96.72 97.06 44 194 4 2 90.91 98.97
FPD Machined Rough 227 534 9 6 96.04 98.88 450 755 13 2 97.11 99.74
Supported Machined 31 2 93.55 16 0 100
overdenture Rough 97 3 96.91 48 0 100
Retained Machined 29 6 79.31 11 0 100
overdenture Rough 20 2 90.00 5 0 100
Telescopic Machined 5 5 0 2 0 100
denture Rough 11 3 72.73 0 0 -
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