Characteristics of Dental Implants at Case Western Reserve University; A Five-year Retrospective Study

Abstract

Objectives: To assess the clinical outcome of dental implants placed at Case Western Reserve University-School of Dental Medicine during the last five years, 2017-2021, and to assess the prevalence and characteristics of complications and failures of dental implants used in a teaching institution. Materials and methods: This study employs a retrospective cross-sectional design examining electronic data from patient charts at the Case Western Reserve University School of Dental Medicine between 2017-2021. The study focuses on patient and implant-related variables. Factors studied include patient demographics, smoking and diabetic status, history of periodontitis, antibiotic usage, and implant characteristics such as manufacturing company, implant dimensions, installation protocol, bone type, type of restoration, presence of peri-implantitis, and implant loss. Patients under 18 or those whose implants lacked post-restoration radiographs were excluded. The research employs descriptive and inferential statistics to investigate the associations between independent variables and the outcomes of peri-implantitis and implant loss. A chi-square test is used to explore these associations, and a multi-level analysis adjusts for implants clustered within patients, minimizing non-independence and Type 1 error. The analysis is computed using SPSS V28 with statistical significance determined by a p-value of <.05. Results: This retrospective study reviews 1301 implants from 727 patients at the Case Western Reserve University School of Dental Medicine between 2017-2021. Most patients were over 40, non-smokers, and non-diabetic. The prevalence of peri-implantitis and early or late implant loss was found to be relatively low (10.4%, 1.7%, and 2.4%, respectively). Antibiotic usage before surgery showed a significant inverse association with peri-implantitis and a borderline inverse association with implant loss. Implant brand and length demonstrated significant association with peri-implantitis but not with implant loss. A strong association was noted between implant loss and peri-implantitis. In a patient-based sub-analysis, implant length, and brand were no longer significantly associated with peri-implantitis, but prophylactic antibiotics usage remained significant, with no peri-implantitis cases in those who received antibiotics before surgery. Conclusions: The retrospective study assessed a substantial number of dental implants over a five-year period. We observed a low incidence of both early and late implant failure, as well as peri-implantitis. Notably, patient or implant-related parameters did not display a significant association with peri-implantitis or implant failure. At the implant level, the implant's length and brand were significantly correlated with peri-implantitis, but this correlation was not observed at the patient level. Prophylactic use of antibiotics prior to the implant procedure