Retrospective Evaluation of Implant Failure Predictors at Tufts University School of Dental Medicine
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ABSTRACT Aim and Hypothesis The objective of this retrospective study is to calculate the presence of failure (implant lost), failing (implant with progressive bone loss >3mm from prosthetic restoration) and success (no additional bone loss following prosthetic restoration) of implants placed at Tufts University School of Dental Medicine (TUSDM) five and up to 8 years following restoration and to determine factors that could be associated with the outcome. Materials and Methods A retrospective record review was conducted on the patients who received implant therapy at Tufts University School of Dental Medicine (TUSDM) from 2004 -2015. This study evaluated tests of association between nominal independent variables and implant status (successes, failing, and failure) conducted with the chi-square test. Multivariable modeling was also be conducted via nominal logistic regression that included (diabetes, smoking, location (maxilla/mandible) and supportive periodontal therapy [SPT]). Results Implant Failure and progressive bone loss rates were 4.6% and 38.2%, respectively. Cardiac disease and supportive periodontal therapy (SPT) were significantly associated with implant status (p = .04, <0.01, respectively), whereas smoking status and diabetes were not (p = .69, .99 respectively). Based on the results from the model, patients who reported cardiac disease were significantly less likely to exhibit progressive bone loss than subjects who did not report the disease, using success as the reference category (OR = .57, 95% CI .35 – .92, p=.02). However, there was no significant association between the two groups of patients i.e., reported cardiac disease and non-reported cardiac disease in terms of implant failure, using success as the reference category(p=.50). Subjects who received SPT were significantly less likely to exhibit progressive bone loss and implant failure than subjects who did not have SPT, using success as the reference category (OR = 2.9, 95% CI 1.8-5.0, p=<0.01, OR = 7.8, 95% CI 2.9- 20, p=<0.01 respectively) Conclusion Within the limitations of this study. Implant failure and progressive bone loss rates were similar to the reported literature. Patients not receiving SPT were more likely to show progressive bone loss and implant failure. Patients who did not report cardiac disease were more likely to present with progressive bone loss.