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Implant Tribune Italian Edition No.3, 2017

8 Ricerca & Clinica Implant Tribune Italian Edition - Settembre 2017 Success, survival and failure rates of dental implants a cross-sectional study AmandafBandeirafdefAlmeida*,fLucianafPradofMaia**,fUmbertofDemonerfRamos**,fSérgiofLuísfScombattifdefSouzacf&fDanielafBazanfPalioto*** * Department of Prosthesis and Periodontology, Faculty of Dentistry, University of Campinas, Piracicaba, Brazil ** Presidente Prudente dental school, University of Western São Paulo, Presidente Prudente, Brazil *** Department of Bucco-Maxilo-Facial Surgery, Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil Introduction The use of dental implants is considered a revolution in modern dentistry1. However, there are differences between professional and patient objectives1. While the patient is usually concerned with esthetics and fun- ction, dental professionals expect success regarding biological and mechanical sta- bility and the facilitation of oral hygiene2. There is consensus among authors that the success of dental implant treatment depen- ds on the presence and maintenance of sur- rounding bone, mainly in the bone crest area. However, one of the major challenges encountered in implantology is the process of bone resorption around the implant after insertion or during its use. In the literature, bone resorption of approximately 1.2 mm in height during the fi rst year of function is re- ported, with 0.1 mm more resorption for eve- ry subsequent year3. This loss with a V or U shape has been called saucerization4. In 1986, Albrektsson et al. established the following criteria for implant success5: The implant should have no mobility and demonstrate no radiolucent areas radiographically, annual vertical bone loss after the fi rst year should be less than 0.2 mm, and there should be no persistent and/or irreversible symptoms. The most common parameter used in clinical re- ports is the survival rate, indicating whether the dental implant is physically in the mouth or has been removed6. However, with this method, implants that should be removed owing to pain or illness may be retained and erroneously considered successful. In 1993, an implant quality of health scale was crea- ted by James and developed by Misch7, 8. This scale was later modifi ed at the Interna tional Congress of Oral Implantologists’ Pisa Con- sensus Conference in 2007, presenting four clinical categories that contain conditions of success, survival and failure of the implant. Survival can be divided into two categories: satisfactory survival, which describes im- plants with less than ideal conditions, but for which there is no need for clinical inter- vention; and compromised survival, which includes implants with less than ideal condi- tions requiring clinical treatment to reduce the risk of implant failure. Implant failure is the term used for implants that require re- moval or that have been lost. Implant success is a term used to describe clinical conditions and must include at least a 12-month period for implants serving as prosthetic abutments. Early success is suggested for implants that are retained for a period of one to three ye- ars, intermediate success for three to seven years and long-term success for a period lon- ger than seven years. In this new approach, pain, mobility, radiographic bone loss, pro- bing depth and periimplant disease are eva- luated9. Regarding periimplant disease, since the bone loss caused by stress or bacteria le- ads to the deepening of the sulcular gap and decreases oxygen tension, anaerobic bacteria become the primary promoter of continuous when the diameter was greater than 5.0 mm. Regarding height, implants were classifi ed as short when they were less than 10 mm, regu- lar when 10–12 mm, and long when greater than 12 mm. The success and survival rates of the implants were analyzed based on the criteria of the Pisa Consensus Conference, ac- cording to the following clinical parameters: pain (absent, absent in function, sensitivity in function, pain in function), mobility (pre- sent or absent), probing depth (PD), bleeding on probing (BOP), exudate (absent, with exu- date history, with uncontrolled exudate) and radiographic bone loss. The PD and BOP measurements were taken at four aspects of each implant: mesial (M), distal (D), buccal (B) and lingual/palatal (L/P). f> pagina 9 Variable Hypertension Diabetes mellitus Smokaing habit None Total n (%) 3 (15.8) 2 (10.5) 5 (26.3) 9 (47.4) 19 (100.0) Table 1: Prevalence of hypertension, diabetes mellitus and tobacco use. Region Anterior Posterior Total Table 2: Dental implant placement area. Mandible n (%) Maxilla n (%) 13 (37.15) 5 (14.30) 13 (37.15) 4 (11.40) 26 (74.30) 9 (25.70) Short (< 10) Regular (10–12) Long (> 12) bone loss9. Exudate or an abscess around an implant indicates exacerbation of periim- plant disease and possibly accelerated bone loss. Exudate persisting for more than one or two weeks normally requires surgical inter- vention in the periimplant area to elimina- te the etiological factors9. The reduced bone height after the exudate episode exposes the implant to secondary occlusal trauma. The dentist should re-evaluate and reduce the stress factors for the new bone condition to improve the performance in the long term9. Considering the importance of maintenance of the crestal bone around dental implants, the aim of this study was to evaluate the suc- cess, survival and failure rates of implants placed over three years based on the implant quality of health scale of the Pisa Consensus Conference. Materiafs and methods This study included 19 patients who recei- ved implants and prostheses on implants in the Implantology Clinic at the School of Dentistry of Ribeirão Preto of the University of São Paulo, Ribeirão Preto, Brazil, between 2007 and 2013. The patients were recalled for clinical and radiographic examinations from three to six years after implant placement. The following criteria were evaluated by in- terview and dental record analysis: age, sex, presence of systemic disease, history of smo- king, area in which the implant was placed, implant diameter and height, and type of prosthesis seated. For the analysis of implant diameter, the fol- lowing classifi cation was used: narrow when the diameter was less than 3.5 mm, regular when the diameter was 4.0–4.8 mm, and wide Height Diameter Narrow (<4.0) Regular (4.0 - 4.8) Total n (%) 3 (8.6) 2 (5.7) 5 (14.3) Table 3: Im5lant distribution according to diameter and height (mm). Variable Absent Varying Presence Table 4: Presence of clinical signs during follow-up. Pain n 34 1 0 n (%) 15 (42.9) 4 (11.4) 9 (25.70) n (%) 10 (28.6) 1 (2.8) 11 (31.4) Exudate Mobility n 33 0 2 n 35 0 0

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