Long-term performance of implants with moderately rough anodized surface supporting single-tooth restorations: A retrospective analysis with an up to 15-year follow-up.

OBJECTIVES: This retrospective study aimed to evaluate long-term clinical and radiologic performance of anodized surface implants supporting single implant restorations. MATERIALS AND METHODS: Patients who received at least one anodized surface implant for a single-tooth restoration between 2003 and 2004 in the Brånemark clinic (Göteborg, Sweden) were included in the study. The assessed outcomes included implant survival, biological and technical complications, as well as marginal bone levels (MBL) based on radiographs. Baseline data on patient demographics, implant placement, and surgery details were also collected. The cumulative survival rate (CSR) was calculated using the Kaplan-Meier survival analysis. RESULTS: The study included 97 patients with 129 implants. Mean patient age at the time of implant placement was 31.7 ± 16.4 years. All implants were placed in a two-stage approach with delayed loading. The last follow-up visit was on average 13.4 ± 4.8 years after implant insertion. Three implants failed, yielding the implant-level 15-year CSR of 97.4%. Majority of the implants had no biological (70.5%) nor technical (81.4%) complications. The mean MBL was -1.0 ± 0.7 mm (n = 101) at prosthetic placement and -1.8 ± 1.0 mm (n = 80) at the last follow-up, while the mean marginal bone loss (MBL) from prosthetic placement to last follow-up was 0.6 ± 1.1 mm (n = 65). CONCLUSIONS: Moderately rough anodized implants have shown favorable long-term outcomessingle-tooth indication, with high survival and a low rate of technical complications. Furthermore, long-term studies are needed to present longitudinal data on peri-implantitis.

Could Age at Surgery Be Associated with Early Mortality After Implant Surgery? A Retrospective Study of 3,877 Edentulous Patients.

PURPOSE: Knowledge of the early mortality patterns in edentulous implant patients is limited. This study aimed to report patient mortality within the first year after surgery and compare the cause of death with preexisting conditions reported before surgery. MATERIALS AND METHODS: In this retrospective cohort study, data from the Swedish National Death Register on patients, consecutively treated in the edentulous arch between 1986 and 2013, were compared with information from the patient files regarding the preexisting health conditions of the deceased patients. One-year survival rates were calculated and compared with expected mortality in a Swedish reference population based on three age groups: young (< 45 years of age), middle-aged (45 to 64 years of age), and old patients (> 64 years of age). Proportions of mortality between study groups and reference populations were tested by means of a log-rank test, and agreement between diagnoses before surgery and cause of death was tested by means of kappa test. RESULTS: Altogether, 3,877 patients were included, of whom 60 patients died within 1 year after implant surgery (1.5%). The expected mortality in the Swedish reference population was 2.1% (P < .05). Mortality was higher for middle-aged (P = .02) but lower for old patients (P = .0001) compared with the Swedish reference populations. Eight of the deceased patients (13%) had no preexisting conditions, while 48 patients reported a health diagnosis before implant surgery. The most common of these were related to the circulatory system (ICD 10-I), which was the cause of death for 30 patients. A "none to slight agreement" between presurgical diagnoses and cause of death was observed in the population (kappa: 0.152). CONCLUSION: Edentulous implant patients presented overall lower mortality than expected in the general population during the first year after surgery. However, middle-aged patients showed a higher proportion of deceased patients compared with control people of the same age. Cardiovascular diseases were the cause of death in 50% of the group, and the agreement between presurgical and cause of death diagnoses was poor.

Mortality in Edentulous Patients: A Registry-Based Cohort Study in Sweden Comparing 8463 Patients Treated with Removable Dentures or Implant-Supported Dental Prostheses.

OBJECTIVES: The purpose of this study was to investigate if edentulism is associated with all-cause mortality. The aims were to analyze the association between age, socioeconomic factors, and mortality in edentulous patients treated with either removable dentures or implant-supported prostheses. METHODS: All patients who became edentulous according to the Swedish Social Insurance Agency (SSIA) between 2009 and 2013 (N = 8463) were analyzed regarding prosthetic treatment, age, gender, and socioeconomic status. The patients were divided into two groups, depending on whether they were treated with dental implants (implant group; IG) or with conventional removable dentures (denture group; DG). Data on mortality for all included individuals were obtained from the Swedish National Cause of Death Register and compared to a reference population. Cumulative survival rates were calculated, and a multivariable regression analysis for the included variables was performed. RESULTS: Between 2009 and 2018, 2192 of the patients (25.9%) were treated with implant-supported dental prostheses (IG) and 6271 patients (74.1%) were treated with removable dentures without support of dental implants (DG). Altogether 2526 patients (30%) died until December 31, 2019, and the overall mortality was significantly higher for the DG compared to the IG during follow-up (p < 0.001). Younger edentulous patients (≤59 years) presented a higher mortality than the reference population, while implant patients over 79 years of age demonstrated a lower mortality. The final results from the multivariable logistic analysis showed that lower equalized disposable income (EDI) and the choice of conventional removable dentures are the most important factors for increased patient mortality (p < 0.001). CONCLUSIONS: Edentulous patients have an overall higher mortality compared to a reference population. Low socioeconomic status increases all-cause mortality. Individuals treated with dental implants show statistically significant lower 10-year mortality compared to patients treated with conventional removable dentures, regardless of socioeconomic status.

Causes of Death in Implant Patients Treated in the Edentulous Jaw: A Comparison between 2098 Deceased Patients and the Swedish National Cause of Death Register.

BACKGROUND: Previous research has reported an association between tooth loss and patient mortality, while the cause of death has not been elucidated. OBJECTIVE: The purpose was to describe and compare the cause of death in implant patients treated consecutively in the edentulous arch with a reference population. METHODS: Altogether, 3902 patients were included between 1986 and 2014. Data on the causes of death for deceased patients were compared to the Swedish National Cause of Death Register for a comparable time period. Standardised mortality ratios (SMRs) were calculated based on gender and age and tested for statistical significance. RESULTS: Most deceased patients (2,098) died from diseases in the circulatory system (CVD; 42%) and from cancers (26%). SMR indicated a generally increased mortality (total group) compared to the reference population during inclusion (P < 0.05; 1986-2014). Patients treated early (1986-1996) showed a lower SMR compared to patients treated later (P < 0.05; 1997-2014) especially related to CVDs. Younger patients (<60 years at surgery) showed an increased mortality due to CVDs when treated late (1997-2014; SMR = 5.4, P < 0.05). Elderly patients (>79 years at surgery) showed a significantly lower mortality in almost all observed causes of death (1986-2014; P < 0.05) with also a significantly lower mortality due to CVDs during the early period (1986-1996; SMR = 0.3, P < 0.05). CONCLUSION: An overall increased mortality was observed for the edentulous implant patient compared to the reference population. Elderly patients (>79 years) showed significantly lower mortality for all causes of death independent of the time period of implant surgery. Younger patients (<60 years) present an increased risk for early mortality related to CVD. SMR for all causes of death increased for patients treated late (1997-2014) as compared to patients treated early (1986-1996).

Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

PURPOSE: Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. MATERIALS AND METHODS: Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. RESULTS: A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P < .05). Furthermore, implant patients in younger age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P < .05). CONCLUSION: A consistent pattern of mortality in different age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

Mortality patterns in partially edentulous and edentulous elderly patients treated with dental implants.

UNLABELLED: An association between oral health, number of teeth, and mortality has been reported in the literature, but limited knowledge is available on mortality in elderly partially edentulous and edentulous patients treated with implants. PURPOSE: The aim of this retrospective study was to compare the mortality pattern in elderly patients (80 years or older) who were provided with implants and were partially or completely edentulous. MATERIALS AND METHODS: Between 1986 and 2003, a total of 266 elderly patients with a mean age of 83.0 years at the time of implant placement were included. The patients were provided with 1,384 Brånemark System implants (Nobel Biocare) in 285 arches. The sample was divided into two subgroups: 108 edentulous patients and 158 partially edentulous patients. Information was collected for each individual regarding expected remaining lifetime at the time of implant surgery. Cumulative survival rate (CSR) was calculated and compared for the two subgroups covering 10 years and was also compared to expected CSR data for normal populations of comparable distribution. RESULTS: Mortality was significantly decreased (P < .05) for partially edentulous compared with edentulous patients (-10.4%) after 10 years of follow-up. CSR for the elderly groups showed a significant decrease in mortality compared with comparable groups of normal populations (P < .05). There was no significant difference in morality between healthy/nonhealthy patients at first surgery or patients with reported/unreported implant failures (P > .05). CONCLUSIONS: Elderly partially edentulous patients had significantly lower mortality compared with edentulous patients over a 10-year period of follow-up. Both subgroups also showed significantly lower mortality compared with normal populations of comparable sex and age at the time of implant surgery. The observation is interpreted as that these patients are healthier and more motivated to replace their lost teeth with implants than the normal population rather than that implant treatment per se reduces mortality.

Fixed implant-supported prostheses in elderly patients: a 5-year retrospective comparison between partially and completely edentulous patients aged 80 years or older at implant surgery.

BACKGROUND: Knowledge on implant treatment in the partially edentulous patient is low for elderly patients aged 80 years or older at inclusion. PURPOSE: The objective of this study was to report and compare the clinical and radiological performance of implant treatment in edentulous and partially edentulous elderly patients during 5 years in function. MATERIAL AND METHODS: Altogether, 192 edentulous (control) and 72 partially edentulous (study) patients, consecutively treated and provided with 1,091 and 265 Brånemark implants, respectively, were included during a period between January 1986 and December 2003, and followed-up for 5 years. Clinical information was retrospectively retrieved from patient files and intraoral radiographs were analyzed for examinations at prosthesis placement and after 1 and 5 years in function. RESULTS: Altogether, 92 (48%) control and 24 (33%) study patients were lost to follow-up during the 5-year period. In total, 13 (4.9%) and 26 (2.4%) implants were in the study and control groups, respectively, were lost during follow-up, resulting in a comparable 5-year implant cumulative survival rate ranging from 93.9% to 99.3% for upper and lower jaws for study and control groups, respectively. Comparable mean marginal bone loss during 5 years, ranging from 0.4 mm to 0.6 mm, was also observed in the groups. The most common complications for patients in both study and control group were soft tissue inflammation (mucositis). Patients included in the first years of the inclusion (1986-1991) period showed comparable results as patient included at the last part of the inclusion period (1998-2003). CONCLUSIONS: Implant treatment in the partially edentulous elderly patients showed comparable clinical and radiographic results as elderly patients treated in the edentulous jaw.