title: Risk factors for dental implant failure: a strategy for the analysis of clustered failure-time observations.
abstract: This study's objective was to identify, in a statistically valid and efficient manner, the risk factors associated with dental implant failure. We hypothesize that factors exist which can be modified by clinicians to enhance outcome. A retrospective cohort study design was used. Cohort members had >or= one implant placed. Risk factors were classified as demographic, health status, implant-, anatomic-, or prosthetic-specific, and reconstructive variables. The outcome variable was implant failure. The cohort was composed of 677 patients who had 2349 implants placed. Based on the adjusted multivariate model, factors associated with implant failure were tobacco use, implant length, staging, well size, and immediate implants (p <or= 0.05). In the setting of correlated survival observations, we recommend adjusting for the correlation of the observations to provide statistically valid and efficient results. Three of the identified factors--tobacco use, immediate implants, and implant staging--potentially may be modified to enhance implant survival.
authors.affiliation: Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Chuang
authors.forename: L J
authors.initials: LJ
authors.lastname: Wei
authors.forename: C W
authors.initials: CW
authors.lastname: Douglass
authors.forename: T B
authors.initials: TB
authors.lastname: Dodson
mesh_terms: D000367:Age Factors; D000465:Algorithms; D000704:Analysis of Variance; D001900:Boston / Q000453:epidemiology; D016000:Cluster Analysis; D015331:Cohort Studies; D015921:Dental Implants / Q000145:classification / Q000706:statistics & numerical data*; D017267:Dental Prosthesis Design / Q000706:statistics & numerical data; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation / Q000601:surgery; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery; D016013:Likelihood Functions; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013499:Surface Properties; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants