Objective: To systematically review the incidence of biological and technical complications in implant therapy reported in prospective longitudinal studies of at least 5 years.

Methods:  A MEDLINE search was conducted for prospective longitudinal studies with follow-up periods of at least 5 years. Screening and data abstraction were performed independently by multiple reviewers. The types of complications assessed were as follows: implant loss, sensory disturbance, soft tissue complications, peri-implantitis, bone loss ≥2.5 mm, implant fracture and technical complications related to implant components and suprastructures.

Results:  The search provided 1310 titles and abstracts, out of which 159 were selected for full-text analysis. Finally, 51 studies were included. Meta analysis of these studies indicated that implant loss prior to functional loading is to be expected to occur in about 2.5% of all implants placed in implant therapy including more than one implant and when routine procedures are used. Implant loss during function occurs in about 2–3% of implants supporting fixed reconstructions, while in overdenture therapy >5% of the implants can be expected to be lost during a 5-year period. Few studies (41% of those included) reported data on the incidence of persisting sensory disturbance >1 year following implant surgery. Most of the studies that provided such data reported on the absence or a low incidence (1–2%) of this complication beyond this interval. A higher incidence of soft tissue complications was reported for patients treated with implants supporting overdentures. There is limited information regarding the occurrence of peri-implantitis and implants exhibiting bone loss ≥2.5 mm. Implant fracture is a rare complication and occurs in <1% of all implants during a 5-year period. The incidence of technical complications related to implant components and suprastructures was higher in overdentures than in fixed reconstructions.

Conclusion:  Implant loss was most frequently described (reported in about 100% of studies), while biological complications were considered in only 40–60% and technical complications in only 60–80% of the studies. This observation indicates that data on the incidence of biological and technical complications may be underestimated and should be interpreted with caution.

A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years

Background:Grafting the floor of the maxillary sinus has become the most common surgical intervention for increasing alveolar bone height prior to the placement of endosseous dental implants in the posterior maxilla. Outcomes of this procedure may be affected by specific surgical techniques, simultaneous versus delayed implant placement, use of barrier membranes over the lateral window, selection of graft material, and the surface characteristics and the length and width of the implants. Rationale:The primary objective of this systematic review was to determine the efficacy of the sinus augmentation procedure and compare the results achieved with various surgical techniques, grafting materials, and implants. Focused Question: In patients requiring dental implant placement, what is the effect on implant survival of maxillary sinus augmentation versus implant placement in the non-grafted posterior maxilla? Search Protocol: MEDLINE, the Cochrane Oral Health Group Specialized Trials Register, and the Database...

/pdf/effect-of-maxillary-sinus-augmentation-on-the-survival-of-4uoigk3y04.pdf

Effect of Maxillary Sinus Augmentation on the Survival of Endosseous Dental Implants. A Systematic Review

The present study was done to determine the long-term success and survival of fixed partial dentures (FPDs) and to evaluate the risks for failures due to specific biological and technical complications. A MEDLINE search (PubMed) from 1966 up to March 2004 was conducted, as well as hand searching of bibliographies from relevant articles. Nineteen studies from an initial yield of 3658 titles were finally selected and data were extracted independently by three reviewers. Prospective and retrospective cohort studies with a mean follow-up time of at least 5 years in which patients had been examined clinically at the follow-up visits were included in the meta-analysis. Publications only based on patients records, questionnaires or interviews were excluded. Survival of the FPDs was analyzed according to in situ and intact failure risks. Specific biological and technical complications such as caries, loss of vitality and periodontal disease recurrence as well as loss of retention, loss of vitality, tooth and material fractures were also analyzed. The 10-year probability of survival for fixed partial dentures was 89.1% (95% confidence interval (CI): 81-93.8%) while the probability of success was 71.1% (95% CI: 47.7-85.2%). The 10-year risk for caries and periodontitis leading to FPD loss was 2.6% and 0.7%, respectively. The 10-year risk for loss of retention was 6.4%, for abutment fracture 2.1% and for material fractures 3.2%.

A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years

Objectives
The objective of this systematic review was to assess the 5- and 10-year survival of implant-supported fixed dental prostheses (FDPs) and to describe the incidence of biological and technical complications.

Methods
An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on FDPs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year and 10-year survival and complication rates.

Results
The updated search provided 979 titles and 257 abstracts. Full-text analysis was performed for 90 articles resulting in a total 32 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants supporting FDPs of 95.6% after 5 years and 93.1% after 10 years. When machined surface implants were excluded from the analysis and only rough surface implants included, the survival rate increased to 97.2% after 5 years. The survival rate of implant-supported FDPs was 95.4% after 5 years and 80.1% after 10 years of function. When the analysis was done exclusively for metal–ceramic FDPs, hence the old gold–acrylic FDPs were excluded, the survival rate increased significantly. The survival rate of metal–ceramic implant-supported FDPs was 96.4% after 5 years and 93.9% after 10 years. Only 66.4% of the patients were free of any complications after 5 years. The most frequent complications over the 5-year observation period were fractures of the veneering material (13.5%), peri-implantitis and soft tissue complications (8.5%), loss of access hole restoration (5.4%), abutment or screw loosening (5.3%), and loss of retention of cemented FDPs (4.7%).

Conclusion
It may be concluded that implant-supported fixed dental prostheses (FDPs) are a safe and predictable treatment method with high survival rates. However, biological and technical complications were frequent (33.6%). To minimize the incidence of complications, dental professionals should make great effort in choosing reliable components and materials for implant-supported FDPs and the patients should be placed in well-structured maintenance system after treatment.

A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years.

Many dental clinical implant studies have fo- cused on the success of endosseous implants with a variety of surface characteristics. Most of the surface alterations have been aimed at achieving greater bone-to-implant con- tact as determined histometrically at the light microscopic level. A previous investigation in non-oral bone under short- term healing periods (3 and 6 weeks) indicated that a sand- blasted and acid-etched titanium (SLA) implant had a greater bone-to-implant contact than did a comparably- shaped implant with a titanium plasma-sprayed (TPS) sur- face. In this canine mandible study, nonsubmerged implants with a SLA surface were compared to TPS-coated implants under loaded and nonloaded conditions for up to 15 months. Six foxhound dogs had 69 implants placed in an alternating pattern with six implants placed bilaterally in each dog. Gold crowns that mimicked the natural occlusion were fabricated for four dogs. Histometric analysis of bone contact with the implants was made for two dogs after 3 months of healing (unloaded group), 6 months of healing (3 months loaded), and after 15 months of healing (12 months loaded). The SLA implants had a significantly higher (p < 0.001) percentage of bone-to-implant contact than did the TPS implants after 3 months of healing (72.33 ± 7.16 versus 52.15 ± 9.19; mean ± SD). After 3 months of loading (6 months of healing) no significant difference was found be- tween the SLA and TPS surfaced implants (68.21 ± 10.44 and 78.18 ± 6.81, respectively). After 12 months of loading (15 months of healing) the SLA implants had a significantly greater percentage (p < 0.001) of bone-to-implant contact than did the TPS implants (71.68 ± 6.64 and 58.88 ± 4.62, respectively). No qualitative differences in bone tissue were observed between the two groups of implants nor was there any difference between the implants at the clinical level. These results are consistent with earlier studies on SLA im- plants and suggest that this surface promotes greater osse- ous contact at earlier time points compared to TPS-coated implants. © 1998 John Wiley & Sons, Inc. J Biomed Mater Res, 40, 1-11, 1998.

http://www.ibmc.up.pt/projectos/FJMonteiro/Bonamidi%20Project/References%20Bonamidi/Cochran%20-%20Bone%20response%20unloaded%20sandblasted%20surface.pdf

Bone response to unloaded and loaded titanium implants with a sandblasted and acid-etched surface : A histometric study in the canine mandible

In the present multi-center study. non-submerged ITI implants were prospectively followed to evaluate their long-term prognosis in fully and partially edentulous patients. In a total of 1003 patients, 2359 implants were consecutively inserted. Following a healing period of 3–6 months, the successfully integrated implants were restored with 393 removable and 758 fixed restorations. Subsequently, all consecutive implants were documented annually up to 8 years. At each examination, the clinical status of all implants was evaluated according to predefined criteria of success. Therefore, the data base allowed the evaluation of 8-year cumulative survival and success rates for 2359 implants. In addition, cumulative success rates were calculated for implant subgroups divided per implant type, implant length. and implant location. Furthermore, the actual 5-year survival and success rates could be determined for 488 implants. During the healing period, 13 implants did not successfully integrate, whereas 2346 implants fulfilled the predefined criteria of success. This corresponds with an early failure rate of 0.55%. During follow-up, 19 implants were classified as failures due to several reasons. In addition, 17 implants (= 0.8%) demonstrated at the last annual examination a suppurative periimplant infection. Including 127 drop out implants (= 5.4% drop out rate) into the calculation, the 8-year cumulative survival and success rates resulted in 96.7% and 93.3%, respectively. The analysis of implant subgroups showed slightly more favorable cumulative success rates for screw type implants (> 95%) compared to hollow-cylinder implants (91.3%). and clearly better success rates for mandibular implants (= 95%) when compared to maxillary implants (= 87%). The actual 5-year survival and success rates of 488 implants with 98.2% and 97.3%. respectively, were slightly better than the estimated 5-year cumulative survival and success rates of 2359 implants indicating that the applied life table analysis is a reliable statistical method to evaluate the long-term prognosis of dental implants. It can be concluded that non-submerged ITI implants maintain success rates well above 90% in different clinical centers for observation periods up to 8 years.

Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants.

This open, single-cohort, multicenter, prospective study investigated the efficacy of immediately provisionalized tapered conical connection implant for single-tooth restorations in the anterior and premolar regions of the maxilla after 5 years of function.All implants were placed in healed sites and immediately provisionalized. MBLs, soft-tissue parameters, and oral-health impact profile (OHIP) were evaluated at implant insertion, 6, 12, 24, 36, and 60 months. Paired Wilcoxon signed-rank tests and Kaplan-Meier survival analysis was used for statistical and implant survival/success analyses, respectively.Seventy-seven patients (81 implants) completed the 5-year follow-up. The 5-year cumulative survival and success rates were 97.8%, and the mean MBL change from implant insertion to 5 years was - 0.80 ± 1.13 mm. Optimal papilla index scores were observed at 90.1% of sites at 5 years compared with 32.8% of sites at insertion. Pink esthetic score, modified bleeding and plaque indices, and OHIP showed statistically significant improvement at the 5-year follow-up.Immediately provisionalized tapered conical connection implants promote marginal bone stability and excellent esthetic outcomes after 5 years of function.This treatment is a viable option for patients requiring immediately provisionalized single-tooth restorations in the esthetic zone and shows favorable long-term clinical outcomes, including marginal bone stability and excellent esthetics. 

https://link.springer.com/content/pdf/10.1007/s00784-021-04328-2.pdf

Immediately provisionalized tapered conical connection implants for single-tooth restorations in the maxillary esthetic zone: a 5-year prospective single-cohort multicenter analysis

/pdf/immediately-provisionalized-tapered-conical-connection-2o47jjjp.pdf

Niklaus Behneke

Papers

Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants.

Immediately provisionalized tapered conical connection implants for single-tooth restorations in the maxillary esthetic zone: a 5-year prospective single-cohort multicenter analysis

Immediately provisionalized tapered conical connection implants for single-tooth restorations in the maxillary esthetic zone: a 5-year prospective single-cohort multicenter analysis