Journal of dentistry · 2025
Risk factors for implant failure of implant-supported fixed full-arch rehabilitation in edentulous maxillae and mandibles: A 1- to 7-year retrospective study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Chen Yunxuan, Pu Rui, Xia Zichun, Yu Ke, Wang Ying, Jiang Zhiwei, Yang Guoli
Аннотация
OBJECTIVE: To evaluate the implant failure rates and risk factors for implant-supported fixed full-arch rehabilitation before and after definitive restoration.
METHODS: This retrospective study assessed patients treated with All-on-4® (5 or 6) implant surgery and immediate loading from January 2018 to April 2024 for inclusion. Patient-, surgery-, and prosthesis-related variables were recorded and analyzed. LASSO regression was used for preliminary variable selection, followed by univariate and multivariate Cox proportional hazards frailty models to identify risk factors for implant failures before and after definitive restoration. Stepwise logistic regression was performed to construct a nomogram predicting implant failure across the entire course.
RESULTS: A total of 141 patients with 840 implants were included. Forty-three patients were treated in the maxilla, 70 in the mandible, and 28 in both jaws, with 377 implants placed in maxillae and 463 in mandibles. The 7-year implant failure rate was 4.52 %, and the cumulative implant survival rate was 91.9 % (95 % CI: 88.4 %-95.6 %). Twenty-one implants failed before definitive restoration and 17 implants failed after definitive restoration. Bone grafting was the independent risk factor before definitive restoration, whereas fewer implants, opposing natural teeth/fixed prostheses, and absence of night guard were independent risk factors after definitive restoration. The nomogram incorporated six predictors associated with implant failure throughout the treatment course (AUC = 0.787).
CONCLUSIONS: Four to six implants-supported fixed full-arch rehabilitation is a predictable treatment. Grafted implant sites are more prone to failure before definitive restoration, whereas fewer implants, opposing natural teeth/fixed prostheses, and absence of night guard are related to implant loss after definitive restoration.
CLINICAL SIGNIFICANCE: Within the limitations of this study, stage-specific risk factors were identified, which may inform clinical decision-making.
METHODS: This retrospective study assessed patients treated with All-on-4® (5 or 6) implant surgery and immediate loading from January 2018 to April 2024 for inclusion. Patient-, surgery-, and prosthesis-related variables were recorded and analyzed. LASSO regression was used for preliminary variable selection, followed by univariate and multivariate Cox proportional hazards frailty models to identify risk factors for implant failures before and after definitive restoration. Stepwise logistic regression was performed to construct a nomogram predicting implant failure across the entire course.
RESULTS: A total of 141 patients with 840 implants were included. Forty-three patients were treated in the maxilla, 70 in the mandible, and 28 in both jaws, with 377 implants placed in maxillae and 463 in mandibles. The 7-year implant failure rate was 4.52 %, and the cumulative implant survival rate was 91.9 % (95 % CI: 88.4 %-95.6 %). Twenty-one implants failed before definitive restoration and 17 implants failed after definitive restoration. Bone grafting was the independent risk factor before definitive restoration, whereas fewer implants, opposing natural teeth/fixed prostheses, and absence of night guard were independent risk factors after definitive restoration. The nomogram incorporated six predictors associated with implant failure throughout the treatment course (AUC = 0.787).
CONCLUSIONS: Four to six implants-supported fixed full-arch rehabilitation is a predictable treatment. Grafted implant sites are more prone to failure before definitive restoration, whereas fewer implants, opposing natural teeth/fixed prostheses, and absence of night guard are related to implant loss after definitive restoration.
CLINICAL SIGNIFICANCE: Within the limitations of this study, stage-specific risk factors were identified, which may inform clinical decision-making.