Dentisterie

Abstrait

Mandibular Implants: A Retrospective Single Private Surgical Practice Study

J Collum*,B Robinson,P Sambrook,A. Goss,A. Lynham

Background: Dental implants have revolutionised restorative dental care but this is complex surgical and prosthodontic treatment. Excellent results have been reported in many institutional studies with a small but acceptable failure rate. It is largely unknown which of these results translate directly into a private practice setting.
Methods: All patients who have dental implants placed in the maxilla by a single oral and maxillofacial surgeon in private practice in over a 3 year period were included in this study. All implants were placed in a two stage approach. All the data was collected through retrospective review of patient files and radiographic assessment. Patient data included full demographics, referral source, type and site of implants placed, and adjunctive procedures. The outcome including any complications in the first phase between placement and uncovering were recorded. The restorative phase was performed by a variety of general dentists and prosthodontists, with patients being followed up in surgical outpatients post final prostheses being issued. In all cases the individual who referred the patient and performed the reconstruction had been present at the time of surgical implantation. The outcome, including any complications in the prosthodontic reconstruction phase was recorded. This data was recorded on a standardised data sheet and maintained and analysed using SPSS (Statistical Package for the Social Sciences, version 9.05, Chicago, IL). Where two different factors were compared, the 95% confidence interval (CI) of the difference between the survival rates was calculated. A difference was considered statistically significant on a 5% level when this confidence level did not contain 0.
Results: 179 mandibular implants were placed in 57 patients. On review at three years 166 (93%) were successful with 13 implant failures. Of the implants which failed, nine of them failed in the first 6 months, and none after 18 months. There were a number of trends which did not reach statistical significance. Failures were more common in the following circumstances; in the posterior mandible (11 of 13), with older mark II & III version implants (12 of 13) and implants shorter than 8 mm. There was no correlation to medical conditions or smoking. An incidental finding was a correlation between those who smoked and had heart disease. (P<0.005)