Peri-Implantitis Clinical Trial
Official title:
The Prediction of Failure Rate of Dental Implants
The aim of the study is to identify predictors in patient profiles and implant characteristics and to develop and calibrate a prediction model for failure of implants. Patients` demographic characteristics, lifestyle habits, general health, dental health, and implant characteristics were regarded as potential predictors. The failure of implants and the follow-up time in days of implants were considered the outcome. Multivariate Cox proportional hazards regression analysis is used to find out the important risk factors for failure of dental implants and to develop the model for prediction of failure of dental implants at follow-up. The performance and clinical values of the model is determined.
During the past decades, dental implant therapy has developed into a successful treatment
option for patients confronted with both partial and complete edentulism. Based on the
literature, the survival rate of dental implants, which is defined that the dental implants
are still in the mouth after insertion, is around 95% in the 5-year follow-up and around 90%
in the 10-year follow-up. The success rate of dental implants, which is defined as dental
implants in function, with good hard and soft tissue physiology and user satisfaction ranges
from 85.2% to 88.7% in the follow-up of up to 20 years. This indicates that both the success
rate and survival rate of dental implants is high. However, both survival rates and success
rates vary across patients with different profiles. The expense of dental implant treatment
is high and implant placement is a surgical procedure which is invasive and thus risky for
the patients' health. Once the failure of dental implants occurs, it may cause some severe
negative consequences for patients. For example, the failure will cause a financial loss for
patients and a possible shock concerning both mental and physical aspects. To reduce these
risks it is important and necessary for clinicians to be able to predict the risk of the
failure of dental implants of individual patients before they undergo dental implant
treatment.
Aim:
The aim of the project is to find out the possible risk factors for failure of dental
implants and to develop a prediction model for the failure of dental implants at follow-up as
a tool for clinicians to establish patients individual risk profile.
Methods:
The study is a retrospective design. The clinical data of the adult patients who were
referred to the Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for
Dentistry Amsterdam (ACTA) for placement of dental implants from September 2009 to September
2013 are collected retrospectively from the clinical data management system of ACTA in the
study.
The potential predictors include five domains: patients` demographic characteristics,
lifestyle habits, general health, dental health, and implant characteristics. These
predictors are pre-screened by international experts in dental implantology based their
clinical knowledge and experience.
The outcomes included the follow-up time of implants and whether the failure of the implants
was observed at the follow-up. The follow-up time is defined as the difference in time
between implant placement and implant failure, or the date of the last follow-up time point
if the dental implant is in an acceptable state. The failure of implants is defined as the
presence of peri-implantitis, presence of mobility of implants, or removal of the implants
for any reasons, for instance, unacceptable performance in aspects of function, tissue
physiology, esthetics, and patients' satisfaction after placement of suprastructure.
The Multivariate Cox proportional hazards regression analysis will be used to find out the
important risk factors and to develop the model. The performance of the model, in aspects of
calibration and discrimination, is assessed. The clinical added values of the model is
assessed. Then, the model is transformed into a score chart and a line chart, which is
easy-to-use to the clinicians for the prediction.
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