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How successful are dental Implants? A personal series of 1000 implants

How successful are dental Implants? A personal series of 1000 implants. Mr Bill Smith Consultant Oral and Maxillofacial Surgeon. Woodland Hospital , Kettering & Three Shires Hospital, Northampton. Method. Retrospective study Data analysed from custom database

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How successful are dental Implants? A personal series of 1000 implants

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  1. How successful are dental Implants?A personal series of 1000 implants Mr Bill Smith Consultant Oral and Maxillofacial Surgeon Woodland Hospital , Kettering & Three Shires Hospital, Northampton

  2. Method • Retrospective study • Data analysed from custom database • Query analysis from Microsoft Access • Age • Frequency of procedure • Implant site • Augmentation • Site of augmentation • Failure • Analysis of failure

  3. Demographics • Total number of implants/fixtures = 1000 • Total number of patients = 490 Most implants(80%) placed between 40 to 69 years of age Number Of implants 86% of patients are non smokers: smoking increases failure of implants both short and long term

  4. Demographics 71% of implants placed at Woodland Hospital, Kettering. 23% placed at Three Shires Hospital ,Northampton.

  5. Implant patients 50% of all patients receive 1 implant, 28% receive 2 implants.

  6. Position of implants Upper/Maxillary implants totals The Incisor region is the commonest site(52%) in the maxilla(upper jaw)

  7. Position of Implants Lower jaw /mandibular implants The Molar region is the commonest site (27%) in the lower jaw c.f upper jaw

  8. Augmentation – Bone grafts Autograft:(human to human) bone Chin : N = 11 Posterior mandible : N = 26 Iliac crest(hip): N = 25 TOTAL Autograft = 62 patients Xenograft bone(animal to human) Total BIO-OSS =50 patients Total Grafts (1997 -2013) N = 113 patients Socket augmentation N = 41 Sinus lift procedures – unilateral and bilateral N = 34 Onlay grafts N = 48

  9. Site of Bone Augmentation UPPER JAW(Maxilla) LOWER JAW(Mandible)

  10. Bone AugmentationSummary Patients own bone now superseded by manufactured Xenografts- BIO-OSS very successful (1% failure) 112 of 490 patients (23% patients) need an augmentation/bone graft of some type Augmentation needed in 263 sites for 1000 implants (26% of all implants) Augmentation much more common in Upper Jaw(89%) than Lower Jaw(11%) Variety of techniques needed 37% of grafts needed in mandibular molar region to maximize bone for implant so reducing risk of Inferior Dental nerve injury.

  11. Failure of implants 15(3%) of 490 patients identified with failed implant(s) Dental Status: 11 patients are DENTATE, 4 patients edentulous. Radiotherapy to Implant site: 8 of 15 patients received radiotherapy to bone PRIOR to implant placement. 20 (2%) fixtures identified as failure – complete loss 13(1.3%) fixtures lost in non-irradiated cases 12(80%) patients with failure identified with previous/pre-existing periodontal disease All patients were non smokers Average time from insertion to failure in 20 fixtures is 27 months(range 3 weeks to 9 years 6 months)

  12. Implant failureFailure by site

  13. Injury to the Inferior dental Nerve Number of implants inserted in the lower second premolar –molar region = 132 Number of Inferior dental nerves injured = 3 Risk of nerve damage per implant = 3/132 =2.2%

  14. Summary • Upper incisor - commonest implant site • 23% of implants preceded by a bone augmentation procedure • Bio-Oss very successful and superseedsautografting techniques • Overall implant failure is 2% • Failure in normal/non radiotherapy cases is 1.3% • 80% of failures associated with previous or pre-existing periodontal disease • Injury to the inferior dental nerve in posterior mandibular implants is 2.2%

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