The use of dental implants is expanding rapidly. Treatment planning for their placement involves the assessment of patient-related risk factors prior to formulation of a treatment plan. The aim of this review was to assess relevant literature and provide evidence-based information on the successful surgical placement of dental implants
The authors conducted a search of Medline, PubMed and the Cochrane Databases of Systematic Reviews and handsearched and cross-referenced with articles cited in papers selected. All levels of evidence were considered; however case reports were excluded if less than 10 patients or if less than one year follow-up. The primary study outcome was implant failure
43 studies were included in the review Many studies contain confounding variables, numbers in subcategories are often too small for meaningful statistical analysis, and follow-up times vary and are often short-term. The table below summarises the current best available evidence for each of the conditions considered.
[table id=11 /]
The authors concluded
There are many risk factors which the clinician is required to know and understand to advise patients, and consider in planning and treatment provision. Consistent evidence exists to show an increased failure rate with smokers, a history of radiotherapy and local bone quality and quantity. Weaker evidence exists to show a higher incidence of peri-implant disease in patients with a history of periodontitis-related tooth loss. Lack of evidence precludes definitive guidelines for patients with autoimmune disorders where expert opinion recommends caution. Osteoporotic patients show acceptable survival rates; however patients on oral bisphosphonates show a small incidence but high morbidity from osteonecrosis of the jaw. Emerging evidence suggests that there is a correlation between genetic traits and disruption of osseointegration.
Liddelow G, Klineberg I. Patient-related risk factors for implant therapy. A critique of pertinent literature. Aust Dent J. 2011 Dec;56(4):417-26. doi:10.1111/j.1834-7819.2011.01367.x. PubMed PMID: 22126353.