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Implant Tribune Italian Edition - Settembre 2017 Ricerca & Clinica 11 f< pagina 10 In addition to these criteria, other factors may be related to the rate of success or failure of the implant, such as age, sex, sy- stemic disease, smoking, area of implant placement, implant diameter and height, additional surgery and bone resorption. In the present study, the success and sur- vival rates were similar among the age groups, corroborating with the findings in the literature that the age of the patient is not related to the implant success rate12–14. Five patients with systemic disease and five with a smoking habit were included in the study. Regarding systemic disea- se, studies have shown that there is no obvious difference in the quality of periimplant tissue15, and this was observed in our stu- dy too, since implants in patients with diabetes were successful. Ho- wever, in smoking patients, there is evidence that the habit has an important influence on the pe- riimplant tissue, regarding both the healing after implant place- ment and the implants’ long-term prognosis16–19. There is a higher risk of inflamma- tion and periimplant bone loss in smokers compared with nonsmo- kers16–19. In our study, the implants placed in smokers did not fail, but 60% of them had bone loss of 2–4 mm, which can be seen as a dubious or even unfavorable pro- gnosis, considering the follow-up period after implant placement. The literature shows a lower suc- cess rate of implants placed in the maxilla compared with the mandible,20 a fact that is related to the lower density of the maxilla- ry bone. The residual bone height becomes insufficient owing to the loss of alveolar bone. However, the molar area in both the maxilla and mandible di- splays substantial bone deficiency owing to increased occlusal for- ces, increasing the failure rate of implants in this area20. In Type IV bone, the cortical bone is very thin, and the lack of dense bone makes it difficult to achieve adequate stability. The mandibu- lar retromolar area and the maxil- lary molar region are formed by low-quality bone, while implants placed in the anterior mandible area have high success rates owing to increased cortical bone. In this study, there was no difference between implants placed in diffe- rent regions of the jaws regarding their success or survival, corrobo- rating the findings of Kim et al.21. It is necessary to consider that the study was conducted with a small number of patients and that pro- bably in a larger sample these dif- ferences would be evident. In our study, various implant systems were analyzed without differences in the success rate or acceptable survival rate, corro- borating the findings of Ferrigno et al.22 and Telleman et al.23, who found similar results for the sur- vival of different types of implant designs. In a literature review, Op- perman et al. also concluded that, regarding implant survival, there are no types, surfaces or implant systems that present clear advantages over others24. In summary, in the present study, 74% of the implants examined were classified as suc- cessful, with excellent prognoses, while 26% of the implants were classified as having im- paired survival. Therefore, success and survival rates of 74% and 100%, respectively, were observed. It is important to highlight that only patients who had undergone definitive prosthetic re- habilitation were evaluated and maybe that is why no failure was observed, since Jeong et al. reported that failure usually occurs before seating of the definitive prosthesis25. Concfusion Within the limitations of this cross-sectio- nal study, the data suggest that the implant success rate does not seem to be related to factors like age, sex, habits, systemic dise- ase, macroscopic characteristics or area in which the implant was placed. This study can be considered preliminary and provides the basis for the design of fur- ther studies. Author contributions ABA, UDR and LPM made substantial con- tributions to conception and design, acqui- sition of data, and analysis and interpreta- tion of data, and wrote substantial parts of the manuscript. ABA, LPM and UDR were involved in drafting the manuscript, parti- cipated in the data analysis and interpreta- tion of the results, and revised critically for important intellectual content. Acknowfedgments This study was supported by a grant (num- ber 2012/25447-5) from the São Paulo Rese- arch Foundation. L’articolo è stato pubblicato su Journal of Oral Science & Rehabilitation No. 2, 2017 Universo Digitale Implantologia Cad-Cam Chirurgia Guidata Centro servizi digitali F22 Aligner Impronta Digitale Dopo 10 anni di ricerca e sviluppo Sweden & Martina presenta il suo flusso digitale: uno strumento completo e testato, al servizio dell’implantologia. sweden-martina.com