Yifat Manor

A retrospective analysis of replacing dental implants in previously failed sites

OBJECTIVEnOverall first-year failure rate for dental implants may reach 3%-8% as the result of various complications. Accordingly, reimplantation accounts for an ever-growing portion of clinics practice. The purpose of the present study was to evaluate the survival rate of dental implants that were performed in sites where failed implants were previously removed and to evaluate the factors affecting outcome.nnnSTUDY DESIGNnThree certified oral and maxillofacial surgeons inserted 144 implant replacement in previously failed sites in 144 patients (1994-2009). Clinical and epidemiologic data were collected retrospectively and analyzed regarding survival rates.nnnRESULTSnSurvival rate of the implants replacing previously failed ones was 93% (133/144). A third placement in the same site was performed in 7 of 11 patients with a survival rate of 85% (6/7) up to the last follow-up. No correlations were found between replaced implant failures with any of the parameters examined.nnnCONCLUSIONSnWithin the limits of the present study, it can be concluded that a previous implant failure should not discourage practitioners from a second or even a third attempt.

Challenges associated with reentry maxillary sinus augmentation

OBJECTIVEnThis study was a retrospective assessment of reentry sinus augmentation compared with sinus augmentation performed for the first time.nnnSTUDY DESIGNnThere were 38 subjects who required sinus augmentation. The study group (17 patients, 21 sinuses) included subjects following failure of a previous sinus augmentation procedure that required reentry augmentation. The control group (21 patients, 21 sinuses) included subjects in which sinus augmentation was performed for the first time. Patients medical files were reviewed. A preformed questionnaire was used to collect data regarding demographic parameters, medical and dental health history, habits, and intra- and postoperative data.nnnRESULTSnOperative challenges in the study group included adhesions of the buccal flap to the Schneiderian membrane (62%, 13/21, P<.001), bony fenestration of the lateral wall with adhesions (71%, 15/21, P<.001), limited mobility of a clinical fibrotic Schneiderian membrane (71%, 15/21, P<.001), and increased incidence of membrane perforations (47%, 10/21, versus 9.5%, 2/21, P=.03). In the control group the Schneiderian membrane was thin and flexible. Sinus augmentation succeeded in all cases of both groups. Implant failure was significantly higher in the study group (11% versus 0%, P<.001).nnnCONCLUSIONSnClinical success of reentry sinus augmentation is predictable despite its complexity. Clinicians should be aware of anatomical changes caused by previous failure of this procedure. Patients should be informed about the lower success rate of implants when reentry sinus augmentation is required.

Dental implants in medically complex patients-a retrospective study.

IntroductionDental implant insertion for oral rehabilitation is a worldwide procedure for healthy and medically compromised patients. The impact of systemic disease risks on the outcome of implant therapy is unclear, since there are few if any published randomized controlled trials (RCTs).ObjectiveThe objective of this study is to investigate the rate of complications and failures following dental implantation in medically compromised patients in order to elucidate risk factors and prevent them.Material and methodsA retrospective cohort study was conducted from patient files treated with dental implantation between the years 2008–2014. The study group consisted of medically complex patients while the control group consisted of healthy patients. Preoperative, intraoperative, and post operative clinical details were retrieved from patients’ files. The survival rate and the success rate of the dental implants were evaluated clinically and radiographically.ResultsA total of 204 patients (1003 dental implants) were included in the research, in the study group, 93 patients with 528 dental implants and in the control group, 111 patients with 475 dental implants. No significant differences were found between the groups regarding implant failures or complications. The failure rate of dental implants among the patients was 11.8xa0% in the study group and 16.2xa0% in the control group (Pxa0=xa00.04). It was found that patients with a higher number of implants (mean 6.8) had failures compared with patients with a lower number of implants (mean 4.2) regardless of their health status (Pxa0<xa00.01).ConclusionsWe found a similar rate of failure and complications of dental implantation in medically complex patients and in healthy patients.Clinical relevanceMedically complex patients can undergo dental implantation. There are similar rates of complications and failures of dental implants in medically complex patients and in healthy patients.