Implant failure predictors in the posterior maxilla: a retrospective study of 273 consecutive implants.
BACKGROUND
The goal of this study was to retrospectively analyze a cohort of 136 patients who underwent dental implant placement in the posterior maxilla at the University of Connecticut Health Center to assess and identify predictors for implant failure in the posterior maxilla.


METHODS
Data were retrieved from patient charts to identify subjects older than 21 years of age who received dental implant(s) in the posterior maxilla. Patients without a postoperative baseline radiograph were excluded. A recall radiograph was taken 3 to 6 months after implant placement. If there was no recall radiograph, the subject was contacted for a recall visit that included a clinical evaluation and radiographs to determine the implant status. Based on a univariate screening, variables considered potential implant failure predictors included gender, diabetes, smoking, implant length, implant diameter, membrane use, sinus-elevation technique, and surgical complications. These parameters were further assessed, and a multivariable logistic regression was performed with implant failure as a dependant variable. All tests of significance were evaluated at the 0.05 error level.


RESULTS
Two hundred seventy-three implants were placed in the posterior maxilla. Fourteen implants failed (early and late failures combined), resulting in a 94.9% overall survival rate. The survival rates for the sinus-elevation group and native bone group were 92.2% and 96.7%, respectively (P = 0.090). Based on the multivariable analysis, sinus floor-elevation procedures were not associated with increased risk for implant failure (P = 0.702). In contrast, smoking and surgical complications had a statistically significant effect on implant failure; the odds ratios for implant failure were 6.4 (P = 0.025) and 8.2 (P = 0.004), respectively.


CONCLUSIONS
Sinus-elevation procedures with simultaneous or staged implant placement do not increase the risk for implant failure, whereas smoking and surgical complications markedly increase the risk for implant failure.
Huynh-Ba
Guy
G
Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030-1710, USA.
Friedberg
J R
JR
Vogiatzi
D
D
Ioannidou
Effie
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003724:Dental Arch / Q000601:surgery; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery; D008567:Membranes, Artificial; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries; D011861:Radiography, Dental; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D013530:Surgical Wound Infection / Q000209:etiology; D016019:Survival Analysis; D055815:Young Adult
D015921:Dental Implants; D008567:Membranes, Artificial