Survival of Dental Implants Placed in Grafted and Nongrafted Bone
Does bone grafting have an effect on implant survival rates? This fascinating, and controversial, question was the aim of a recent study1 that compared dental implant survival rates when placed in native bone and grafted sites. It was based on retrospective chart review for patients receiving dental implants at the University of Texas, School of Dentistry from 1985 to 2012. A total of 1,222 patients with 2,729 implants were included.
Conclusion: There was no difference in the dental implant survival rate when implants were placed in native bone or bone-grafted sites. Smoking and lack of professional maintenance were significantly related to increased implant loss.
Thoughts?
Read the Full Study Abstract Here.
1. Int J Oral Maxillofac Implants. 2016 Mar-Apr;31(2):310-7. doi: 10.11607/jomi.4681. Survival of Dental Implants Placed in Grafted and Nongrafted Bone: A Retrospective Study in a University Setting.Tran DT, Gay IC, Diaz-Rodriguez J, Parthasarathy K, Weltman R, Friedman L.
7 Comments on Survival of Dental Implants Placed in Grafted and Nongrafted Bone
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Dr. Joe Favia
4/5/2016
The study makes sense since the same healing factors would be present in grafted as well as in natural bone.. As long as the grafted bone had it's time to heal.. both should heal the same.
Dennis Flanagan DDS MSc
4/5/2016
Retrospective studies are mid level credibility. Also the University patient population was probably highly selected and not reflective of a private practice. The extent of grafting may be an issue. The greater the thickness we ask bone to fill then there may be less dense bone and more risk for poor support. Ridge splitting is probably more successful than grafting facial augmentation. Ridge splitting means the osteo-perioosteal flap, flapless or open flapped.
Dennis Flanagan DDS MSc
gary OMS
4/6/2016
Dear Dennis,
I can' t agree with that, unfortunately.
I've been doing a few of these splits, one- stage in the upper an later on two- stage technique in the lower. This was done to prevent the patient having a bone transplant surgery from the iliac crest or calvarium. I' ve found lots of cervical bone resorption at uncovering the implants. I used APRF, bone substitutes to fill the gap, and collagen membranes and had no issues with flap closure.
The thing is: there must be a critical bone width to do the splitting, both for viability of the bone 'flap' ( = vascularity ) and to compensate enough for resorption. I think this has to be around 4 or 5 mm. But in that case, why bother with such an extensive technique while you can place narrow diameter implants ( 3- 3,5 mm ) and add some bone substitute? Half the time, half the sweat, same result. The splitting techniques are derived from ancient pre prosthetic surgery procedures; before the development of reliable bone substitutes and implants. They were fun to do but quite unpredictable when it comes to bone resorption, in my hands.
Peter Fairbairn
4/6/2016
Having just published a retrospective study on a new Grafting/placement protocol I agree there are limitations but it is the length of time and number of cases that is hard to have with a prospective study .
What we do see routinely is higher Osstell readings in Implants placed in grafted sites than host bone , but we always use fully resorpable materials ....
The notion that quantity is all that needs to be assessed is flawed and Bone quality will become more of an issue in the future . Retained graft materials ( HA ) tends to lead to a much reduced quality of the regenerated host bone and this may be an issue. ( HL Chan , HL Wang , Systemic Review JOMI 2013)
Regards
Peter
Fabey Dental Studios
4/7/2016
Properly explained about survival of dental implants. Well differentiated how maintenance therapy reduced the failure rate and tobacco increased the failure rate of implants.
greg steiner
4/8/2016
This in one serious mess of a study. They vast amount of implants in the sturdy were 3 years or less even though they say it is a 10 year study. They included any implant that was placed in any type of grafting procedure and they don't list the failures in relation to the procedure even thought they have the information. Worse yet they do not list the type of graft material associated with the failures even though they have the information. They have an 87% success rate in no graft but a 79% in grafted sties. You mean to tell me that in a large pool of patients if one group has 8% more failures that is not significant? 8 more failures out of a 100 is a big deal to me. When I see valuable data left out of a study it implies to me they are intentionally not telling us the whole truth. Greg Steiner Steiner Biotechnology
greg steiner
4/8/2016
This in one serious mess of a study. They vast amount of implants in the sturdy were 3 years or less even though they say it is a 10 year study. They included any implant that was placed in any type of grafting procedure and they don't list the failures in relation to the procedure even thought they have the information. Worse yet they do not list the type of graft material associated with the failures even though they have the information. They have an 87% success rate in no graft but a 79% in grafted sties. You mean to tell me that in a large pool of patients if one group has 8% more failures that is not significant? 8 more failures out of a 100 is a big deal to me. When I see valuable data left out of a study it implies to me they my not be telling us the whole truth. Greg Steiner Steiner Biotechnology
