ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Survival Rates of Implants Placed in Previously Failed Sites Are Decreased But Clinically Acceptable
Clinical Question How does the survival rate of implants placed in previously failed sites compare to that of first-attempt implants?
Clinical Bottom Line Survival rates of implants placed in previously failed sites are not as high as those commonly cited for initially placed implants (~ 95%) but are still clinically acceptable. A systematic review of seven articles, including case series and retrospective clinical cohort studies, supports the concept of replacing previously failed implants. Considering the relatively good prognosis of such treatment patients are likely to be receptive to this treatment.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 27183062Zhou/20167 studies/396 patients/470 successive implantsSystematic review of non-randomized trials
Key resultsSecond-attempt implants had an average survival rate of 88.84% with 390 of 439 implants surviving. Included studies showed a second-attempt implant survival range of 71% to 94.6%. Second-attempt implants were followed for an average of 41.59 +/- 16.77 months. Twenty-three out of 31 third-attempt implants survived for an average 74.2% survival rate. Studies included had a third-attempt implant survival range of 50% to 100%. Third-attempt implants were followed for an average of 29.66 +/- 14.71 months. Only 4 of the 7 studies analyzed identified the type of implant restoration. Single crowns were the most common restoration with fixed partial dentures being the second most common.
Evidence Search systematic[sb] AND (failed dental implants) [PubMed Clinical Queries search]
Comments on
The Evidence
Validity: No randomized controlled trials could be located for this systematic review. The overall risk of bias for the seven studies included in the systematic review was moderate. Perspective: The systematic review discusses, but does not reach any conclusions about, potential factors which may contribute to the survival or failure of successive implants. These are areas which should be studied further and warrant consideration during treatment planning.
Applicability Patients today are less inclined to accept treatment plans with a removable prosthesis as a definitive treatment. In cases where previously placed implants have failed, successive implants may be attempted with clinically acceptable, although decreased, survival rates. Patients should be advised of the possibility of a higher failure rate. Since bone loss can accompany implant failure and its associated removal, patients should be informed about the possible need for bone augmentation and related costs. Additionally, the surgeon should consider factors that may have contributed to the failure and those which may contribute to the successive implant’s survival. Some factors to be considered include the width of the implant and the implant surface, as well as individual patient risk factors.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Dental Implants, Implant Failure, Implant Survival
ID# 3099
Date of submission: 11/06/2016spacer
E-mail millerm10@livemail.uthscsa.edu
Author Mandy Miller, DMD
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Guy Huynh-Ba, DDS, MS
Faculty mentor/Co-author e-mail HuynhBa@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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