Skip to main content
Erschienen in:

Open Access 01.12.2016 | Research

Retrospective analysis of 10,000 implants from insertion up to 20 years—analysis of implantations using augmentative procedures

verfasst von: Wolfram Knöfler, Thomas Barth, Reinhard Graul, Dietmar Krampe

Erschienen in: International Journal of Implant Dentistry | Ausgabe 1/2016

Abstract

Background

A sufficient amount of bone is essential to ensure long-term stability of dental implants. To support the bone regeneration process, different techniques and materials are available. It has been questioned whether these techniques and materials may compromise implant survival compared to pristine bone. To properly answer this question, long-term stability up to 20.2 years after insertion of implants placed in augmented or non-augmented sites was retrospectively analysed.

Methods

Retrospective analysis included 10,158 implants from 3095 patients in three private practices who underwent implant therapy with or without bone augmentation procedures. Different graft materials and membranes were used for augmentation. If necessary, the graft was stabilised using a titanium mesh. Implant survival was evaluated analysing explantation rates and Kaplan-Meier survival curves in augmented or non-augmented sites. In additional subgroup analyses, augmentation procedures, graft materials and membranes were compared applying descriptive statistics.

Results

The observation period varied from the day of implantation up to 20.2 years after implant insertion. The overall implant survival was 95.5% (augmented sites 96.33%; native sites 94.27%). Comparison of Kaplan-Meier survival curves revealed significantly better survival of implants in augmented sites (p = 0.0025). When comparing different augmentation procedures, the best results were found for bone condensing followed by lateral augmentation. Graft materials were used in 58.2%, membranes in 36.6% of all implant sites. The most often used graft materials were a deproteinized bovine bone mineral (53.0%) and autogenous bone particles (32.5%). Both provided the best results and showed a significantly better implant survival compared to no graft material using the Kaplan-Meier method (p = 0.0104 and p < 0.0001). A native collagen membrane was used most often (74.0% of the membrane sites) and provided the best results regarding implant survival in the log-rank test.

Conclusions

The retrospective analysis shows that implants inserted in augmented or native bone demonstrate similar implant survival under the conditions of private practice compared to prospective studies. To establish a broad base of support, further well-designed clinical trials are necessary.

Background

Replacing missing teeth with dental implants is a routine treatment in many dental practices. In order to achieve adequate functional and aesthetic results, an optimal three-dimensional implant position has to be assured [1]. Various materials are available to build up missing bone. While autogenous bone is usually regarded to be the gold standard, harvesting may be associated with morbidity and considerable post-operative resorption of the augmented volume [2]. Therefore, bone substitutes are often used either alone or in combination with autogenous bone. Among bone substitutes, deproteinized bovine bone mineral has proven effectiveness in various indications as shown in clinical studies [37]. The long-term stability of the augmented volume found with this material is probably due to its slow resorption rate [8].
In guided bone regeneration procedures, membranes are often used to cover the graft and prevent ingrowth of soft tissue [9]. Native collagen membranes have been shown to allow bone formation with a low complication rate [6, 1012].
Questions have been raised whether implant survival may be compromised in augmented sites since graft materials might impede and delay bone remodelling. While some studies reported reduced survival for implants in grafted areas [13, 14], other authors did not report any significant differences of implant survival or implant success between augmented and pristine bone [15, 16]. For sinus floor augmentation, Aghaloo et al. even found favourable implant survival rates in augmented bone [17].
Therefore, the objective of this study was to retrospectively analyse all consecutively placed implants in patients fulfilling the inclusion criteria and complete patient data files within 20 years in three private practices in terms of implant survival in augmented and non-augmented sites. Secondary objectives were to evaluate whether certain augmentation procedures or materials may be advantageous in terms of implant survival.

Methods

The retrospective analysis evaluates patients who underwent implant therapy with or without accompanying augmentation procedures between August 1991 and December 2011 in three private practices. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. To investigate the effect of the different techniques applied on implant survival without overlapping impact of contraindications, the following exclusion criteria were applied: patients with uncontrolled diabetes mellitus, severe cardiovascular diseases (e.g. severe heart insufficiency), organ transplants, intake of bisphosphates and smoking of ≥20 cigarettes/day. Only patients with complete data regarding implantation procedure and implant survival were included. During this time period, a total of 10,165 implants were inserted either with or without augmentation. Seven implants were excluded from the evaluation because the date of implantation was not documented. Thus, 10,158 implants in 3095 consecutively treated patients were included in the retrospective analysis. Of these patients, 1693 (54.7%, 5626 implants) were female, 1401 (45.3%, 4539 implants) were male. For one patient, the sex was not documented. Mean age at the time of the implantation was 52.4 years (14.8 to 89.5). There was no difference regarding age or distribution of sex between patients with or without augmentation. On average, female patients received 3.32 and male patients 3.24 implants per patient.
Surgeries as well as pre- and postsurgical care were performed according to the standard procedures used in the three centres. Implants were inserted according to the manufacturers’ instructions. Patients were scheduled 3 months post-implantation followed by yearly control visits after the completion of the implant-supported restorative therapy.
The following graft materials were used: autogenous bone blocks, autogenous bone particles, Geistlich Bio-Oss (granules or collagen block, Geistlich Pharma AG, Wolhusen, Switzerland), Cerasorb (Curasan, Kleinostheim, Germany), Bioresorb (Implant Direct, Zurich, Switzerland), Bonitmatrix (DOT, Rostock, Germany), Biovin Bovine Bone (OT Medical, Bremen, Germany), Nanobone (Artoss, Rostock, Germany), Osteograf (Dentsply Tulsa Dental Specialities, Oklahoma, USA), Biogran (Biomet 3i, Munich, Germany), Easygraft (Degradable Solutions, Zurich, Switzerland), Endobone (Biomet 3i Deutschland GmbH, Munich, Germany), Pepgen P15 (Dentsply Tulsa Dental Specialities, Oklahoma, USA), Bioseed Oral Bone (Biotissue AG, Freiburg, Germany), Ostim (Heraeus Kulzer, Hanau, Germany), Perioglass (Novabone, Jacksonville, FL, USA) and Rebone (Schütz Dental GmbH, Rosbach, Germany). Autogenous bone was harvested during drilling and from the chin, tibial plateau, iliac crest, maxillary tuberosity and retromolar space.
The membranes applied included the native collagen membrane Geistlich Bio-Gide (Geistlich Pharma AG, Wolhusen, Switzerland) either alone or combined with one of the following membranes: Vicryl (Johnson & Johnson Medical GmbH, Norderstedt, Germany), Biovin Membran (OT Medical, Bremen, Germany), Parasorb Vlies (Resorba, Nuremberg, Germany), Gore-Tex Resolut (W.L. Gore & Associates, Flagstaff, USA), Kollagenresorb (RESORBA Medical GmbH, Nuremberg, Germany), Epi-Guide (DSM, Exton, USA), Gore Resolut Adapt Regenerative Membrane (W.L. Gore & Associates, Flagstaff, USA), Osseoguard (Biomet 3i, Munich, Germany), Ossix (Tel Aviv, Israel), Parasorb Resodont (RESORBA Medical GmbH, Nuremberg, Germany), Tefgen (Lifecore Biomedical, Chaska, USA), Tutodent (Tutogen, Neunkirchen, Germany), non-resorbable Gore-Tex membrane (GT, W.L. Gore & Associates, Flagstaff, USA), Osseoquest (W.L. Gore & Associates, Flagstaff, USA) and Inion GTR (Curasan, Kleinostheim, Germany). If a titanium mesh was used (Tiomesh, Dentaurum, Germany), the membranes were placed over the mesh.
Patient data files were analysed regarding personal patient information, implantation process and implantation outcome in terms of implant loss. Patient data included information about the sex, date of birth, the number and position of implants placed as well as the date of implantation and explantation or last control visit. Regarding the implantation procedure, the use of graft materials and membranes were documented.
Collected data were retrospectively analysed in terms of explantation rates to evaluate the survival between implants undergoing augmentation or not. Additional subgroup analysis included comparisons of different augmentation procedures, graft materials and membranes. In order to compare augmentation procedures, they were categorised into lateral augmentation, three-dimensional augmentation using a titanium mesh, bone splitting/bone spreading, use of autogenous bone blocks, internal sinus floor augmentation using the Osteotome technique and external sinus floor augmentation using a lateral window approach (one- and two-step procedure), bone condensing or combinations of these procedures. Bone splitting/spreading and bone condensing describe accompanying augmentation procedures to equalise the bone level with neighbouring sites.

Statistical evaluation

The statistical analysis was performed using SPSS 11.0.0 (IBM, Armonk, NY, USA) as well as SAS Version 9.2 (SAS Institute Inc., Cary, NC, USA). Metric parameters were descriptively analysed for arithmetic mean and standard deviation. To test the hypothesis of “no differences between augmented sites and non-augmented sites in regard to survived implants”, survival of implants was compared based on Kaplan-Meier survival curves using log-rank test and included patient data up to a 20.2-year observation period [18]. Subgroups were exploratory analysed for statistical differences using log rank. A p value of 0.05 was regarded to be significant.

Results

Of the 10,158 implants, 58.2% (5916 implants) were inserted using an augmentation procedure. The minimal observation period until the last control visit or until explantation was 0 days (day of implantation); the maximum period was 20.2 years. Distribution of analysed implants according to the period of observation is shown in Table 1.
Table 1
Distribution of implants according to the period of observation
Year
Number of implants
Relative number of implants (%)
<1
1920
18.9
1
1175
11.6
2
843
8.30
3
918
9.04
4
794
7.82
5
779
7.67
6
728
7.17
7
578
5.69
8
531
5.23
9
454
4.47
10
346
3.41
11
297
2.92
12
247
2.43
13
169
1.66
14
104
1.02
15
104
1.02
16
56
0.55
17
71
0.70
18
22
0.22
19
19
0.19
20
1
0.01
NA
2
0.02
Total
10158
100.0
NA observation period not clearly determinable
A total of 4.53% (460 implants) of all implants were lost during the observation period of 20.2 years. Analysis of early and late implant loss revealed that 16 implants (0.38%) without and 19 implants (0.32%) with augmentation were extracted before connection to the suprastructure, whereas 227 implants (5.35%) without and 198 implants (3.35%) with augmentation were lost after the attachment of the suprastructure within a 20.2-year observational period. Statistical analysis using Kaplan-Meier method and log-rank test revealed significantly better (p = 0.0025) survival curves for implants inserted with augmentation (96.33% of functional implants) compared to implants without augmentation (94.27% of functional implants) (Table 2 and Fig. 1). This was also true if only single-crown implants were evaluated, where the proportion of surviving implants was 98.84% (23 explantations of 1980 implants) with augmentation and 97.01% (34 explantations of 1136 implants) without augmentation (p = 0.0028).
Table 2
Implant loss in augmented and non-augmented sites up to 20.2 years after implant insertion
Augmentation
Implants (n)
Lost implants % (n)
Early implant loss % (n)
Late implant loss % (n)
Absolute survival rate %
No augmentation
4242
5.73 (243)
0.38 (16)
5.35 (227)
94.27
With augmentation
5916
3.67 (217)
0.32 (19)
3.35 (198)
96.33
Total
10158
4.53 (460)
0.34 (35)
4.18 (425)
95.47
Early implant loss (before connection of the suprastructure), late implant loss (after connection of the suprastructure). Metric parameters are calculated using descriptive statistics

Augmentation procedures

The augmentation procedures performed most frequently were lateral ridge augmentation and external one-step sinus floor augmentation (Table 3). During the observation period of 20.2 years, the percentage of surviving implants ranged between 95.0 and 98.5% and therefore slightly exceeded the one of no augmentation (Table 3). However, in pairwise comparisons, significant differences vs. no augmentation were only found for lateral augmentation as well as for external and internal sinus floor augmentations. In 57 implants, sinus lift was combined with other augmentation procedures. The absolute implant survival rate was 94.74% in these sites (p = 0.8826 vs. no augmentation). Kaplan-Meier implant survival curves are shown in Fig. 2.
Table 3
Explantations of implants inserted using different augmentation procedures up to 20.2 years after implantation
Augmentation procedure
Implants
(n)
Lost implants % (n)
Absolute survival rate %
p value
No augmentation
4242
5.72 (243)
94.28
 
Lateral augmentation
3210
4.02 (129)
95.98
0.0010
External sinus lift one-step
1101
4.09 (45)
95.91
0.0324
Bone condensing
422
1.90 (8)
98.1
0.0009
Bone splitting/bone spreading
374
3.74 (14)
96.26
0.2998
Internal sinus lift
314
2.55 (8)
97.45
0.0174
Autogenous bone block transplantation
241
3.32 (8)
96.68
0.1146
External sinus lift two-step
130
1.54 (2)
98.46
0.0410
Three-dimensional augmentation using Ti-mesh
124
2.42 (3)
97.58
0.1159
Metric parameters are based on descriptive statistics. P values for pairwise comparison vs. no augmentation were calculated in accordance to Kaplan and Meier using log-rank test.
When looking into the Kaplan-Meier implant survival curves of the augmentation procedures using the log-rank test, the highest implant survival was found for bone condensing followed by lateral augmentation, internal sinus lift, transplantation of bone blocks, bone splitting/spreading, titanium mesh, external sinus lift (one- and two-step) and finally, no augmentation. This sequence was statistically significant (p = 0.0336).

Membranes

In 36.6% of all implant sites, a membrane was used. In 74.0% of these sites, the native collagen membrane Geistlich Bio-Gide was applied. Other often used membranes were Geistlich Bio-Gide combined with other membranes (7.38%), the non-resorbable Gore-Tex membrane (6.19%) and Vicryl (6.03%).
In pairwise comparisons vs. no membrane, significantly increased rates of implant loss were found for Kollagen Vlies and Resodont, although the sample sizes were quite small (Table 4). When evaluating the Kaplan-Meier implant survival curves for the membranes (Fig. 3) using the log-rank test, the following sequence for implant survival was found (p = 0.0009): Geistlich Bio-Gide (highest survival), Gore-Tex, Tefgen, Ossix, Biovin, Ossoguard, Epigude, Inion, Geistlich Bio-Gide in combination with other membranes, Vicryl, Resodont, Kollagen Vlies, Tutodent, and no membrane (lowest survival).
Table 4
Explantations of implants per membrane type up to 20 years after implant insertion
Membrane type
Implants
(n)
Min/max observation time (years)
Lost implants % (n)
Absolute survival rate %
p value
No membrane
6439
0.0/20.2
4.77 (307)
95.23
 
Geistlich Bio-Gide
2743
0.0/16.2
3.76 (103)
96.24
0.4462
Geistlich Bio-Gide combined with other membranes
279
0.0/10.2
3.23 (9)
96.77
0.7809
Gore-Tex
230
0.4/18.5
5.65 (13)
94.35
0.1671
Vicryl
224
0.0/18.4
6.70 (15)
93.3
0.6808
Tefgen
81
0.2/16
2.47 (2)
97.53
0.1638
BioVin M
65
0/1.9
1.54 (1)
98.46
0.7816
Tutodent
49
0.1/5.9
8.16 (4)
91.84
0.0555
Resodont
21
0.1/3.6
14.29 (3)
85.71
0.0021
Kollagen Vlies
10
0.1/9.7
30.0 (3)
70
0.0006
Ossix
8
8.0/8.9
0.00 (0)
100
0.4781
Osseoguard
4
2.3/3.2
0.00 (0)
100
0.7061
Curasan InionGTR
3
1.0/1.0
0.00 (0)
100
0.7694
Epigide
2
4.9/4.9
0.00 (0)
100
0.7680
Total
10158
0.0/20.2
4.53 (460)
95.47
 
Metric parameters were calculated using descriptive statistics. P values for pairwise comparison vs. no membrane were calculated in accordance to Kaplan and Meier using log-rank test

Graft materials

The graft materials used most often were the deproteinized bovine bone mineral, Geistlich Bio-Oss (53.0%) and autogenous bone particles (32.5%). The use of both graft materials resulted in higher absolute implant survival assessing the data to no graft material (p = 0.0104 and p < 0.0001). In contrast, Cerasorb showed lower implant survival compared to no graft material (p = 0.0002). For the other materials, no differences were found (Table 5).
Table 5
Implants lost and in function up to 20.2 years after implant insertion using different graft materials
Graft material
Implants (n)
Min/max observation time (years)
Lost implants % (n)
Absolute survival rate %
p value
No graft material
4609
0.0/20.2
5.51 (254)
94.49
 
Geistlich Bio-Oss
2939
0.0/15.6
2.76 (81)
97.24
0.0004
Autogenous bone particles
1801
0.0/17.8
3.94 (71)
96.06
0.1807
Cerasorb
284
0.0/12.6
10.56 (30)
89.44
0.0007
Bioresorb
145
0.1/11.6
6.90 (10)
93.10
0.7782
Bio-Oss + Cerasorb
105
0.0/5.8
2.86 (3)
97.14
0.6714
Other bone substitutes
275
0.0/18.6
4.00 (11)
96
0.1354
Total
10158
0.0/20.2
4.53 (460)
95.47
 
Metric parameters were calculated applying descriptive statistics. P values for pairwise comparison vs. no graft material were calculated in accordance to Kaplan and Meier using log-rank test.
When comparing the Kaplan-Meier implant survival curves of the grafts (Fig. 4) to each other using the log-rank test, the following sequence for implant survival was found (p = 0.0001): Geistlich Bio-Oss (highest survival), other bone substitutes, autogenous bone particles, Geistlich Bio-Oss + Cerasorb, Bioresorb, Cerasorb and no graft material (lowest survival).

Discussion

The retrospective analysis presented here evaluates implants inserted in three different private practices with or without augmentation procedures. Treatments were performed according to the standard protocols applied in the private practices. More than 10,000 implants were inserted in various indications and were followed up to 20.2 years from the day of implant insertion. The overall implant survival rate was 95.5%. When only single-crown implants were evaluated, the absolute survival rate increased to 98.8%. Various reviews have reported about the implant survival similar to the results found here [15, 17, 19].
In our analysis, survival of the 10,158 implants analysed was slightly but significantly higher in augmented bone than in pristine bone (96.3 vs. 94.3%). This might result from an increased mineral density, as usually observed after augmentation, and the concomitant higher bone-to-implant contact [20]. High number of implants analysed here allowed suited statistical analysis despite of patient- and implant-specific variations. According to the statistical results of survival curves, the hypothesis of no difference might be withdrawn in favour for augmented bone indicating a statistically significant positive effect of grafting on implant survival. However, small difference in absolute numbers should be carefully evaluated for clinical relevance. Previously, published studies regarding implant survival between augmented and non-augmented sites are inconclusive. In one retrospective analysis which included 12,737 implants in 4206 patients, 59.7% of the implants were inserted using bone augmentation or bone expanding procedures [16]. The authors did not find a significant difference between the Kaplan-Meier cumulative survival rates among grafted and non-grafted sites. In a recent review which included 108 articles of all evidence levels, Jensen and Terheyden found a high level of evidence that survival rates of implants in augmented bone are very similar to the ones of implants in pristine bone [15]. In another review, Aghaloo et al. reported similar or even better results for implants in augmented sites [17]. However, there are also a few clinical studies in which reduced survival rates for implants inserted in grafted areas were found [13, 14]. Differences in numbers of implants analysed, surgical techniques, indications and/or graft materials may account for these inconsistent results and further studies might be needed.
In the retrospective analysis shown here, the comparison of different augmentation procedures using the log-rank test revealed the highest implant survival for bone condensing followed by lateral ridge augmentation. The lowest rankings were found for sinus floor augmentation and no augmentation. In pairwise comparisons of Kaplan-Meier implant survival curves to non-augmented sites, a significantly higher implant survival was found for lateral bone augmentation and sinus floor elevation. However, all procedures provided a high implant survival of more than 94%. This indicates that under daily practice all these augmentation procedures may provide clinically acceptable results. Recent reviews have also reported a high implant survival of more than 90% for sinus augmentation [5, 15, 17, 2123], lateral ridge augmentation [15, 19, 24, 25], for bone splitting [21, 26] as well as for three-dimensional augmentations using titanium mesh [27]. When augmentation procedures were compared to each other, the authors were not able to draw a clear conclusion on the superiority of a certain augmentation procedure or grafting protocol [15, 17, 21, 28].
In our analysis, membranes were used in 36.6% of the implant sites. Small defects were treated with either a bone substitute or bone particles without an additional membrane. The membrane which was used in almost 75% of the cases was a native collagen membrane. Various other studies have reported successful results using this membrane in bone augmentation [6, 1012] as well as a low complication rate [29, 30]. Although in our analysis, the membrane was associated with a high absolute survival rate of 96.24% and the best result in the log-rank test, it is still not possible to draw clear conclusions on the superiority of any membrane, when implant survival is the only parameter under consideration.
The most often used graft material in our evaluation was Geistlich Bio-Oss (53.0%) followed by autogenous bone (32.5%). When compared to no graft, the use of both grafts resulted in significantly higher implant survival rates. In various studies, the bone substitute was found to promote bone regeneration and to allow for long-term stability of the augmented volume [3, 58, 3133]. A recent meta-analysis compared Geistlich Bio-Oss and autogenous bone [24]: For maxillary sinus floor augmentation, a mean implant survival rate of 98.6 ± 2.6% was found for bone substitute, 88.6 ± 4.1% for autogenous bone + bone substitute and 97.4 ± 2.2% for autogenous bone alone. While there was a trend in favour of Geistlich Bio-Oss, the differences were not statistically significant. When the authors evaluated the studies with vertical and/or lateral alveolar ridge augmentation, they found similar mean implant survival rates for the three treatment modalities (97.4 ± 2.5% for Geistlich Bio-Oss, 100 ± 0.0% for autogenous bone + Geistlich Bio-Oss, 98.6 ± 2.9% for autogenous bone alone). Data is based on 4687 implants in 1816 patients. This finding is in line with the results from our study. In contrast to Geistlich Bio-Oss, the use of a synthetic material (Cerasorb) resulted in a significantly lower implant survival than no graft in the pairwise comparison, although in the log-rank test, the synthetic material demonstrated better results than no graft material used. However, the heterogeneity of the data does not allow drawing statistical conclusions on the superiority between those bone substitutes that were used rather rarely.
The retrospective analysis presented here included a large number of implants followed up to 20.2 years. While it allows conclusions on the efficacy of augmentation procedures in daily practice, there are some limitations. It was not possible to evaluate the initial defect size and morphology. Therefore, it is not clear whether the different graft materials and membranes were used in comparable clinical situations or whether differences in original defect size may have accounted for some of the differences in survival rates. In addition, the data were only evaluated for implant survival and not for implant success. This is due to the fact that in clinical studies, the success of dental implants is commonly defined by implant survival. Although different criteria for implant success were suggested in the 1980s and early 1990s [32, 3437], the success rate addressing prosthetic, biological and aesthetic complications was largely absent from the literature in the 1990s and was newly established only 5 to 10 years ago. Despite of the international proposed criteria, a common consensus could not be reached so far. In addition, Buch et al. compared the different criteria proposed for implant success with regard to their clinical value [38]. The authors demonstrated that the proposed criteria led to very different success rates 6 years after implant insertion (75–89%) and did not allow reliable comparison of the results with each other. Thus, during control visits in our practices, only prosthetic complications, but no other factors essential on reporting implant success rates were documented. Especially in the anterior maxilla, the documentation of factors essential for a good aesthetic outcome with long-term stability would be of high importance. Another fact is that all inserted implants were intentionally included, irrespective of the indication, the augmentation materials used and irrespective of whether they were already in function or not. It would be of interest to evaluate the potential impact of different implantation and augmentation procedures on early and late implant loss as other authors could show remarkable effect on early and late implant failure [39, 40].
Due to this, clear conclusions on the advantages of certain procedures, materials, healing or loading times are not possible and might be subject to further discussion. According to a retrospective 10-year observation, most implant failures occurred before loading [41]. In most of the cases, the clinical cause was unclear, but 17.5% were due to iatrogenic conditions and only 3% could be attributed to poor bone quality and quantity. This, together with our own analysis suggests that early implant loss is related to a learning curve and the surgeons’ experience, as we have encountered that early implant loss was halved after approximately every 500 implants.
Nevertheless, our analysis indicates that under the conditions of daily practice, implants in augmented bone have survival rates that tend to be even better than implants inserted in native bone.

Conclusions

In this retrospective analysis, more than 10,000 implants were included followed up to 20.2 years. They were inserted in a variety of indications either with or without augmentation procedures. While it was not possible to draw clear conclusions on the superiority of a certain augmentation procedure, a graft material or a membrane as the indication for the different materials and procedures might vary; the data indicated that implant survival in augmented bone may be slightly better than in pristine bone. Further well-designed, prospective, randomised, long-term studies are needed to get greater insights into this subject.

Acknowledgements

We would like to thank Stefan Weber (ACOMED STATISTics, Leipzig, Germany) for the fruitful collaboration and the excellent statistical analysis he performed on the patient data.

Authors’ contributions

WK, TB and RG initiated and designed the retrospective study. TB and RG supervised the PhD students who collected and reviewed the data retrospectively. All authors interpreted the data. WK drafted the manuscript including the preparation of the figures and tables. DK performed the literature acquisition which was evaluated by the other authors. All authors revised the manuscript and approved the final manuscript.

Competing interests

The statistical analysis was financially supported by the company DENTSPLY (International, York, PA, USA). Dr. Dietmar Krampe is employed at DENTSPLY. Nevertheless, the authors do not believe that the above mentioned disclosure presents any apparent competing interest with respect to the content and subject matter of the retrospective analysis shown here.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Literatur
1.
Zurück zum Zitat Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19(Suppl):43–61.PubMed Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19(Suppl):43–61.PubMed
2.
Zurück zum Zitat Nkenke E, Neukam FW. Autogenous bone harvesting and grafting in advanced jaw resorption: morbidity, resorption and implant survival. Eur J Oral Implantol. 2014;7 Suppl 2:S203–17.PubMed Nkenke E, Neukam FW. Autogenous bone harvesting and grafting in advanced jaw resorption: morbidity, resorption and implant survival. Eur J Oral Implantol. 2014;7 Suppl 2:S203–17.PubMed
3.
Zurück zum Zitat von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.CrossRef von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.CrossRef
4.
Zurück zum Zitat Chen ST, Darby IB, Reynolds EC. A prospective clinical study of non-submerged immediate implants: clinical outcomes and esthetic results. Clin Oral Implants Res. 2007;18:552–62.CrossRefPubMed Chen ST, Darby IB, Reynolds EC. A prospective clinical study of non-submerged immediate implants: clinical outcomes and esthetic results. Clin Oral Implants Res. 2007;18:552–62.CrossRefPubMed
5.
Zurück zum Zitat Jensen T, Schou S, Stavropoulos A, Terheyden H, Holmstrup P. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft: a systematic review. Clin Oral Implants Res. 2012;23:263–73.CrossRefPubMed Jensen T, Schou S, Stavropoulos A, Terheyden H, Holmstrup P. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft: a systematic review. Clin Oral Implants Res. 2012;23:263–73.CrossRefPubMed
6.
Zurück zum Zitat Jung RE, Fenner N, Hammerle CH, Zitzmann NU. Long-term outcome of implants placed with guided bone regeneration (GBR) using resorbable and non-resorbable membranes after 12-14 years. Clin Oral Implants Res. 2013;24:1065–73.CrossRefPubMed Jung RE, Fenner N, Hammerle CH, Zitzmann NU. Long-term outcome of implants placed with guided bone regeneration (GBR) using resorbable and non-resorbable membranes after 12-14 years. Clin Oral Implants Res. 2013;24:1065–73.CrossRefPubMed
7.
Zurück zum Zitat Urban IA, Nagursky H, Lozada JL, Nagy K. Horizontal ridge augmentation with a collagen membrane and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: a prospective case series in 25 patients. Int J Periodontics Restorative Dent. 2013;33:299–307.CrossRefPubMed Urban IA, Nagursky H, Lozada JL, Nagy K. Horizontal ridge augmentation with a collagen membrane and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: a prospective case series in 25 patients. Int J Periodontics Restorative Dent. 2013;33:299–307.CrossRefPubMed
8.
Zurück zum Zitat Jensen SS, Bosshardt DD, Gruber R, Buser D. Long-term stability of contour augmentation in the esthetic zone: histologic and histomorphometric evaluation of 12 human biopsies 14 to 80 months after augmentation. J Periodontol. 2014;85:1549–56.CrossRefPubMed Jensen SS, Bosshardt DD, Gruber R, Buser D. Long-term stability of contour augmentation in the esthetic zone: histologic and histomorphometric evaluation of 12 human biopsies 14 to 80 months after augmentation. J Periodontol. 2014;85:1549–56.CrossRefPubMed
9.
Zurück zum Zitat Hammerle CH, Jung RE, Feloutzis A. A systematic review of the survival of implants in bone sites augmented with barrier membranes (guided bone regeneration) in partially edentulous patients. J Clin Periodontol. 2002;29 Suppl 3:226–31. discussion 32-3.CrossRefPubMed Hammerle CH, Jung RE, Feloutzis A. A systematic review of the survival of implants in bone sites augmented with barrier membranes (guided bone regeneration) in partially edentulous patients. J Clin Periodontol. 2002;29 Suppl 3:226–31. discussion 32-3.CrossRefPubMed
10.
Zurück zum Zitat Visser A, Raghoebar GM, Meijer HJ, Meijndert L, Vissink A. Care and aftercare related to implant-retained dental crowns in the maxillary aesthetic region: a 5-year prospective randomized clinical trial. Clin Implant Dent Relat Res. 2011;13:157–67.CrossRefPubMed Visser A, Raghoebar GM, Meijer HJ, Meijndert L, Vissink A. Care and aftercare related to implant-retained dental crowns in the maxillary aesthetic region: a 5-year prospective randomized clinical trial. Clin Implant Dent Relat Res. 2011;13:157–67.CrossRefPubMed
11.
Zurück zum Zitat Buser D, Chappuis V, Bornstein MM, Wittneben JG, Frei M, Belser UC. Long-term stability of contour augmentation with early implant placement following single tooth extraction in the esthetic zone: a prospective, cross-sectional study in 41 patients with a 5- to 9-year follow-up. J Periodontol. 2013;84:1517–27.PubMed Buser D, Chappuis V, Bornstein MM, Wittneben JG, Frei M, Belser UC. Long-term stability of contour augmentation with early implant placement following single tooth extraction in the esthetic zone: a prospective, cross-sectional study in 41 patients with a 5- to 9-year follow-up. J Periodontol. 2013;84:1517–27.PubMed
12.
Zurück zum Zitat Cordaro L, Torsello F, Chen S, Ganeles J, Bragger U, Hammerle C. Implant-supported single tooth restoration in the aesthetic zone: transmucosal and submerged healing provide similar outcome when simultaneous bone augmentation is needed. Clin Oral Implants Res. 2013;24:1130–6.CrossRefPubMed Cordaro L, Torsello F, Chen S, Ganeles J, Bragger U, Hammerle C. Implant-supported single tooth restoration in the aesthetic zone: transmucosal and submerged healing provide similar outcome when simultaneous bone augmentation is needed. Clin Oral Implants Res. 2013;24:1130–6.CrossRefPubMed
13.
Zurück zum Zitat Becktor JP, Isaksson S, Sennerby L. Survival analysis of endosseous implants in grafted and nongrafted edentulous maxillae. Int J Oral Maxillofac Implants. 2004;19:107–15.PubMed Becktor JP, Isaksson S, Sennerby L. Survival analysis of endosseous implants in grafted and nongrafted edentulous maxillae. Int J Oral Maxillofac Implants. 2004;19:107–15.PubMed
14.
Zurück zum Zitat Sesma N, Pannuti C, Cardaropoli G. Retrospective clinical study of 988 dual acid-etched implants placed in grafted and native bone for single-tooth replacement. Int J Oral Maxillofac Implants. 2012;27:1243–8.PubMed Sesma N, Pannuti C, Cardaropoli G. Retrospective clinical study of 988 dual acid-etched implants placed in grafted and native bone for single-tooth replacement. Int J Oral Maxillofac Implants. 2012;27:1243–8.PubMed
15.
Zurück zum Zitat Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. Int J Oral Maxillofac Implants. 2009;24(Suppl):218–36.PubMed Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. Int J Oral Maxillofac Implants. 2009;24(Suppl):218–36.PubMed
16.
Zurück zum Zitat Krebs M, Schmenger K, Neumann K, Weigl P, Moser W, Nentwig GH. Long-term evaluation of ANKYLOS(R) dental implants, part i: 20-year life table analysis of a longitudinal study of more than 12,500 implants. Clin Implant Dent Relat Res. 2015;17 Suppl 1:e275–86.CrossRefPubMed Krebs M, Schmenger K, Neumann K, Weigl P, Moser W, Nentwig GH. Long-term evaluation of ANKYLOS(R) dental implants, part i: 20-year life table analysis of a longitudinal study of more than 12,500 implants. Clin Implant Dent Relat Res. 2015;17 Suppl 1:e275–86.CrossRefPubMed
17.
Zurück zum Zitat Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22(Suppl):49–70.PubMed Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22(Suppl):49–70.PubMed
18.
Zurück zum Zitat Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. Am Stat Assoc. 1958;53:457–81.CrossRef Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. Am Stat Assoc. 1958;53:457–81.CrossRef
19.
Zurück zum Zitat Kuchler U, von Arx T. Horizontal ridge augmentation in conjunction with or prior to implant placement in the anterior maxilla: a systematic review. Int J Oral Maxillofac Implants. 2014;29(Suppl):14–24.CrossRefPubMed Kuchler U, von Arx T. Horizontal ridge augmentation in conjunction with or prior to implant placement in the anterior maxilla: a systematic review. Int J Oral Maxillofac Implants. 2014;29(Suppl):14–24.CrossRefPubMed
20.
Zurück zum Zitat Haas R, Baron M, Zechner W, Mailath-Pokorny G. Porous hydroxyapatite for grafting the maxillary sinus in sheep: comparative pullout study of dental implants. Int J Oral Maxillofac Implants. 2003;18:691–6.PubMed Haas R, Baron M, Zechner W, Mailath-Pokorny G. Porous hydroxyapatite for grafting the maxillary sinus in sheep: comparative pullout study of dental implants. Int J Oral Maxillofac Implants. 2003;18:691–6.PubMed
21.
Zurück zum Zitat Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24(Suppl):237–59.PubMed Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24(Suppl):237–59.PubMed
22.
Zurück zum Zitat Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant Dent Relat Res. 2012;14 Suppl 1:e159–68.CrossRefPubMed Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant Dent Relat Res. 2012;14 Suppl 1:e159–68.CrossRefPubMed
23.
Zurück zum Zitat Del Fabbro M, Wallace SS, Testori T. Long-term implant survival in the grafted maxillary sinus: a systematic review. Int J Periodontics Restorative Dent. 2013;33:773–83.CrossRefPubMed Del Fabbro M, Wallace SS, Testori T. Long-term implant survival in the grafted maxillary sinus: a systematic review. Int J Periodontics Restorative Dent. 2013;33:773–83.CrossRefPubMed
24.
Zurück zum Zitat Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone - a systematic review and meta-analysis. Eur J Oral Implantol. 2014;7 Suppl 2:S219–34.PubMed Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone - a systematic review and meta-analysis. Eur J Oral Implantol. 2014;7 Suppl 2:S219–34.PubMed
25.
Zurück zum Zitat Aloy-Prosper A, Penarrocha-Oltra D, Penarrocha-Diago M, Penarrocha-Diago M. The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: a systematic review. Med Oral Patol Oral Cir Bucal. 2015;20:e251–8.CrossRefPubMedPubMedCentral Aloy-Prosper A, Penarrocha-Oltra D, Penarrocha-Diago M, Penarrocha-Diago M. The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: a systematic review. Med Oral Patol Oral Cir Bucal. 2015;20:e251–8.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Bassetti MA, Bassetti RG, Bosshardt DD. The alveolar ridge splitting/expansion technique: a systematic review. Clin Oral Implants Res. 2016;27:310–24.CrossRefPubMed Bassetti MA, Bassetti RG, Bosshardt DD. The alveolar ridge splitting/expansion technique: a systematic review. Clin Oral Implants Res. 2016;27:310–24.CrossRefPubMed
27.
Zurück zum Zitat Rasia-dal Polo M, Poli PP, Rancitelli D, Beretta M, Maiorana C. Alveolar ridge reconstruction with titanium meshes: a systematic review of the literature. Med Oral Patol Oral Cir Bucal. 2014;19:e639–46.CrossRefPubMedPubMedCentral Rasia-dal Polo M, Poli PP, Rancitelli D, Beretta M, Maiorana C. Alveolar ridge reconstruction with titanium meshes: a systematic review of the literature. Med Oral Patol Oral Cir Bucal. 2014;19:e639–46.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res. 2006;17 Suppl 2:136–59.CrossRefPubMed Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res. 2006;17 Suppl 2:136–59.CrossRefPubMed
29.
Zurück zum Zitat Tal H, Kozlovsky A, Artzi Z, Nemcovsky CE, Moses O. Long-term bio-degradation of cross-linked and non-cross-linked collagen barriers in human guided bone regeneration. Clin Oral Implants Res. 2008;19:295–302.CrossRefPubMed Tal H, Kozlovsky A, Artzi Z, Nemcovsky CE, Moses O. Long-term bio-degradation of cross-linked and non-cross-linked collagen barriers in human guided bone regeneration. Clin Oral Implants Res. 2008;19:295–302.CrossRefPubMed
30.
Zurück zum Zitat Schwarz F, Sculean A, Bieling K, Ferrari D, Rothamel D, Becker J. Two-year clinical results following treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane. J Clin Periodontol. 2008;35:80–7.CrossRefPubMed Schwarz F, Sculean A, Bieling K, Ferrari D, Rothamel D, Becker J. Two-year clinical results following treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane. J Clin Periodontol. 2008;35:80–7.CrossRefPubMed
31.
Zurück zum Zitat Elnayef B, Monje A, Lin GH, Gargallo-Albiol J, Chan HL, Wang HL, et al. Alveolar ridge split on horizontal bone augmentation: a systematic review. Int J Oral Maxillofac Implants. 2015;30:596–606.CrossRefPubMed Elnayef B, Monje A, Lin GH, Gargallo-Albiol J, Chan HL, Wang HL, et al. Alveolar ridge split on horizontal bone augmentation: a systematic review. Int J Oral Maxillofac Implants. 2015;30:596–606.CrossRefPubMed
32.
Zurück zum Zitat Albrektsson T, Jansson T, Lekholm U. Osseointegrated dental implants. Dent Clin North Am. 1986;30:151–74.PubMed Albrektsson T, Jansson T, Lekholm U. Osseointegrated dental implants. Dent Clin North Am. 1986;30:151–74.PubMed
33.
Zurück zum Zitat Lindhe J, Cecchinato D, Donati M, Tomasi C, Liljenberg B. Ridge preservation with the use of deproteinized bovine bone mineral. Clin Oral Implants Res. 2014;25:786–90.CrossRefPubMed Lindhe J, Cecchinato D, Donati M, Tomasi C, Liljenberg B. Ridge preservation with the use of deproteinized bovine bone mineral. Clin Oral Implants Res. 2014;25:786–90.CrossRefPubMed
34.
Zurück zum Zitat Buser D, Weber HP, Lang NP. Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollow-cylinder and hollow-screw implants. Clin Oral Implants Res. 1990;1:33–40.CrossRefPubMed Buser D, Weber HP, Lang NP. Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollow-cylinder and hollow-screw implants. Clin Oral Implants Res. 1990;1:33–40.CrossRefPubMed
35.
Zurück zum Zitat Jahn M, d’Hoedt B. Zur Definition des Erfolges bei dentalen Implantaten. Zeitschrift für Zahnärztliche Implantologie. 1992;8:221–6. Jahn M, d’Hoedt B. Zur Definition des Erfolges bei dentalen Implantaten. Zeitschrift für Zahnärztliche Implantologie. 1992;8:221–6.
36.
Zurück zum Zitat Naert I, Quirynen M, van Steenberghe D, Darius P. A six-year prosthodontic study of 509 consecutively inserted implants for the treatment of partial edentulism. J Prosthet Dent. 1992;67:236–45.CrossRefPubMed Naert I, Quirynen M, van Steenberghe D, Darius P. A six-year prosthodontic study of 509 consecutively inserted implants for the treatment of partial edentulism. J Prosthet Dent. 1992;67:236–45.CrossRefPubMed
37.
Zurück zum Zitat Dental implants. Benefit and risk. NIH Consens Statement Online 1978. National Institutes of Health Consensus Development Conference. 1978. p. 13–9. Dental implants. Benefit and risk. NIH Consens Statement Online 1978. National Institutes of Health Consensus Development Conference. 1978. p. 13–9.
38.
Zurück zum Zitat Buch RS, Weibrich G, Wagner W. Criteria of success in implantology. Mund Kiefer Gesichtschir. 2003;7:42–6.CrossRefPubMed Buch RS, Weibrich G, Wagner W. Criteria of success in implantology. Mund Kiefer Gesichtschir. 2003;7:42–6.CrossRefPubMed
39.
Zurück zum Zitat Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94:44S–51.CrossRefPubMedPubMedCentral Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94:44S–51.CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Alsaadi G, Quirynen M, Komarek A, van Steenberghe D. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection. J Clin Periodontol. 2007;34:610–7.CrossRefPubMed Alsaadi G, Quirynen M, Komarek A, van Steenberghe D. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection. J Clin Periodontol. 2007;34:610–7.CrossRefPubMed
41.
Zurück zum Zitat Montes CC, Pereira FA, Thome G, Alves ED, Acedo RV, de Souza JR, et al. Failing factors associated with osseointegrated dental implant loss. Implant Dent. 2007;16:404–12.CrossRefPubMed Montes CC, Pereira FA, Thome G, Alves ED, Acedo RV, de Souza JR, et al. Failing factors associated with osseointegrated dental implant loss. Implant Dent. 2007;16:404–12.CrossRefPubMed
Metadaten
Titel
Retrospective analysis of 10,000 implants from insertion up to 20 years—analysis of implantations using augmentative procedures
verfasst von
Wolfram Knöfler
Thomas Barth
Reinhard Graul
Dietmar Krampe
Publikationsdatum
01.12.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Implant Dentistry / Ausgabe 1/2016
Elektronische ISSN: 2198-4034
DOI
https://doi.org/10.1186/s40729-016-0061-3

Weitere Artikel der Ausgabe 1/2016

International Journal of Implant Dentistry 1/2016 Zur Ausgabe

Neu im Fachgebiet Zahnmedizin

Sechs Monate E-Rezept – Erfolgsgeschichte mit Schattenseiten

IT für Ärzte Nachrichten

244 Millionen E-Rezepte sind in sechs Monaten eingelöst worden: Nach einem halben Jahr zieht die Betriebsgesellschaft gematik eine positive Zwischenbilanz. Doch noch sind nicht alle Akteure begeistert.

So können sich Praxen vor Cyberkriminalität schützen

IT für Ärzte Nachrichten

Immer wieder werden Arztpraxen Opfer von Netzverbrechern. Der typische Hacker war einmal, Cyberkriminalität ist sehr vielfältig, berichtet Lars Korunalp. Der IT-Berater gibt Tipps und nennt konkrete Maßnahmen, wie sich Praxen vor Zugriffen aus dem Internet schützen können.

Thüringer Landtag beschließt Vorab-Quote im Medizinstudium

Bewerber, die sich zu einer langen Tätigkeit als Haus- oder Zahnarzt in Thüringen verpflichten, bekommen in Jena künftig leichter einen Studienplatz. Sechs Prozent der Plätze sollen so vergeben werden.

Notfallreform: Lauterbach nimmt KVen und ausgewählte Kliniken in die Pflicht

06.06.2024 Klinik aktuell Nachrichten

Die Ampelkoalition nimmt einen neuen Anlauf für die Reform der Notfallversorgung. Der Gesetzentwurf zeigt: Die Vertragsärzte müssen sich auf erhebliche Veränderungen in der Organisation der Notdienste einstellen.

Update Zahnmedizin

Bestellen Sie unseren kostenlosen Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.