Analysis of the Causes for Failure of ITI Dental Implants

Analysis of the Causes for Failure of ITI Dental Implants
L.M. ADRIAENS, M. VAN ASCH, and P.A. ADRIAENS, International Center for Periodontology & Oral Implants, Brussels, Belgium
March 2004
Clinical Implant Studies
Objectives: To analyze the causes for implant failure, i.e. implant loss, in a patient population treated with ITI dental implants by 1 operator and followed during a period of 8 years. Methods: 894 consecutive sites (in 337 patients) received ITI dental implants in maxillary (59%) and mandibular (41%) sites. 431 sites (48%) had been edentulous for more than 1 year. 31% of these sites needed preliminary bone volume augmentation surgery. In 454 sites (52%) extraction had been performed recently. 79% of these sites received alveolar bone protection (ABP). Implants were placed between 2 and 4 months following extraction+ABP and between 6 and 8 months after GBR procedures. In posterior maxillary sites elevation of the sinus mucosa was needed in 42 sites and was performed with the insertion of an autologous bone/Bio-Oss mixture through the implant site. Results: Twelve (1.2%) implants had to be removed: 7 (1.7%) in the upper and 5 (0.8%) in the lower jaw. Early implant failures occurred between 4 and 10 months. These implants failed to osseo-integrate: 6 in the upper jaw and 1 in the lower jaw. Most of these were 8 mm TPS treated implants with reduced diameter (3.3 mm). Immediate failure appeared to be linked to presence of plaque, sinus mucosa elevation and trauma from temporary prosthesis. Late failures occurred after an average of 7 years: 3 in the upper and 2 in the lower jaw. In all cases plaque control was deficient. In 4 cases the patient smoked more than 20 cigarettes/day. In 2 cases trauma due to solder joint fracture or bruxism was present. Conclusion: Failure of ITI dental implants are rare and can be traced to a limited number of causes, mainly poor plaque control, smoking, trauma and insufficient bone quality.