title: Peri-implant complications for posterior endosteal implants.
abstract: OBJECTIVE
  (1) To assess whether there is evidence of an association between the number of peri-implant tissue complications and patient characteristics such as gender, diabetes status, smoking status, and bite force; (2) To assess whether there is evidence of an association between the number of peri-implant tissue complications and location of the implant, surgical technique used, bone graft status and sinus lift status.
  
  
  METHODS
  This randomized, controlled clinical trial included a total of 176 implants (OsseoSpeed, DENTSPLY) in 67 participants with 88 fixed dental prostheses. Information was obtained from health histories, a baseline exam, surgical notes, and post-operative exams. The data were analyzed using Fisher's exact and Mann-Whitney tests and generalized estimating equations using logistic regression with a significance level set at 0.05.
  
  
  RESULTS
  All 176 implants survived within a recall period of 3 years, but 11 implants demonstrated peri-implant tissue complications. Ten sites showed dehiscence and one case exhibited vertical bone loss. There was a statistically significant association between surgical technique used (1-stage or 2-stage) and the presence of soft tissue complications (P = 0.005), where 2-stage surgery was associated with a higher frequency of peri-implant soft tissue complications. A correlation, although not statistically significant (P = 0.077), was noted, between peri-implant tissue complications and bone grafting, suggesting a possible role for this factor as well.
  
  
  CONCLUSIONS
  Participants who did not require any second-stage surgery at the implant sites experienced fewer complications. Therefore, additional surgical procedures should be performed judiciously considering their possible effects on peri-implant tissue health.
  
  
  CONCLUSIONS
  The clinical implication of this research study is that secondary surgery should be considered with caution during implant placement and it should be performed only when other options have been exhausted, as it has been shown to have a direct adverse effect on the long-term peri-implant tissue health.
authors.affiliation: Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors.forename: Josephine
authors.initials: J
authors.lastname: Esquivel-Upshaw
authors.affiliation: Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Mehler
authors.affiliation: Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Clark
authors.affiliation: Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Neal
authors.affiliation: Department of Oral Surgery, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors.forename: Luiz
authors.initials: L
authors.lastname: Gonzaga
authors.affiliation: Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Anusavice
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D059546:Sinus Floor Augmentation; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants
keywords: bone graft; bone loss; implant failure; implant success; soft tissue complications