More than a dental implantBrand matters!

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The authors used data from the Swedish Social Insurance Agency which covers all individuals >20years of age receiving dental care in a public or private setting in Sweden.

Out of >23’000 patients who received implant treatment in the year

2003, the authors randomly selected 2765 patients to evaluate

earl implant loss. Additionally, late implant loss was evaluated

in 596 patients 9 years after treatment.

Study design

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Study design.

Evaluation of early implant loss

Evaluation of late implant loss

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Risk of early implant loss compared to Straumanndental implants, expressed as “Odds ratio “ (OR)

Results.

overall

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Risk of late implant loss compared to Straumanndental implants, expressed as “Odds ratio “ (OR)

Results.

overall

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1 Buser D, Janner SF, Wittneben JG, Bragger U, Ramseier CA, Salvi GE.10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study

in 303 partially edentulous patients. Clin Implant Dent Relat Res. 2012 Dec;14(6):839-51. PubMed PMID: 22897683

These findings are extremely relevant for dentists and patients who want to choose an implant system on the basis of independent published clinical evidence.

The results add to the unparalleled body of long-term clinical data supporting Straumann’s dental implant system.

Impressive long-term outcomes have been reported with Straumann implants in other peer-reviewed publications, including 10-year survival rates of 97 – 99 % in more than 600 patients1.

Conclusions.

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J. Derks*, J. Håkansson, J.L. Wennström, C. Tomasi, M. Larsson, and T. Berglundh. Effectiveness of Implant Therapy Analyzed in a Swedish Population – Early and Late Implant Loss

Published online before print December 11, 2014, doi: 10.1177/0022034514563077 JDR December 11, 2014 0022034514563077.

http://jdr.sagepub.com/content/early/2014/12/11/0022034514563077.abstract?rss=1

Source.

The Journal of Dental Research is one of the highest ranked journals in the field

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Patient enrollment (n = number of patients).

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Implant loss.

Implant-related Information retrieved from Patient Files.

All data in this table are given in percentages.

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Factors associated with early implant loss: p≤0.05 regarded as statistically significant.

Implant brands: A, Straumann implant group; B, Nobel Biocare implant group; C, Astra Tech implant group; D, other.

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Factors associated with late implant loss: p≤0.05 regarded as statistically significant.

Implant brands: A, Straumann implant group; B, Nobel Biocare implant group; C, Astra Tech implant group; D, other.

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An «Odds Ratio» is a statistical way to express an effect. In case of the Derks study, the authors calculated how manyimplants were lost in the «Astra», «Nobel» or «Others» groupcompared to the «Straumann group».

Under most real world circumstances, the odds ratio is a good estimate of the risk if the risk of that sth. happens (remark//in our case “implant loss”//) is low. (Source: Epidemiology, Biostatistics, and Preventive Medicine" Jekel J. et al, 2007; Page 92/93)

Remark: Low risk means <5% (Sometimes even <10%) which is the case: In our study, early implant loss occured in 4,4%of patients (1,4 %of implants), late implant loss occured in 4,2% of patients (2,0% of implants).

Odds Ratio (OR).

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Abstract: Treatment outcomes in implant dentistry have been mainly assessed as implant survival rates in small, selected patient groups of specialist or university clinical settings. This study reports on loss of dental implants assessed in a large and randomly selected patient sample. The results were aimed at representing evaluation of effectiveness of implant dentistry. Using the national data register of the Swedish Social Insurance Agency, 4,716 patients were randomly selected. All had been provided with implant-supported restorative therapy in 2003. Patient files of 2,765 patients (11,311 implants) were collected from more than 800 clinicians. Information on patients, treatment procedures, and outcomes related to the implant supported restorative therapy was extracted from the files. In total, 596 of the 2,765 subjects, provided with 2,367 implants, attended a clinical examination 9 y after therapy. Implant loss that occurred prior to connection of the supraconstruction was scored as an early implant loss, while later occurring loss was considered late implant loss. Early implant loss occurred in 4.4% of patients (1.4% of implants), while 4.2% of the patients who were examined 9 y after therapy presented with late implant loss (2.0% of implants). Overall, 7.6% of the patients had lost at least 1 implant. Multilevel analysis revealed higher odds ratios for early implant loss among smokers and patients with an initial diagnosis of periodontitis. Implants shorter than 10 mm and representing certain brands also showed higher odds ratios for early implant loss. Implant brand also influenced late implant loss. Implant loss is not an uncommon event, and patient and implant characteristics influence outcomes

(ClinicalTrials.gov NCT01825772).

Additional information from the paper

Key findings: The multilevel analysis in the present study disclosed that implant brand also influenced late implant loss. As was the case for differences between implant brands regarding early implant loss, the data from the present material did not provide explanations for the differences in late implant loss. In addition, there may be several reasons for late implant loss, such as progressive marginal bone loss, damages on the interface between the implant and the bone tissue, or harm to the implant, including implant fracture.