Failure of Wide-Diameter Dental Implants (Predominantly 5.0 mm) Show Distinct Risk Profiles-A Large Cohort Study

Area of Science:

• Dental Implantology
• Oral Surgery
• Biomaterials Science

Background:

• Wide-diameter dental implants (≥5.0 mm) are increasingly used.
• Understanding their long-term survival and failure risk factors is crucial for clinical practice.
• Distinct mechanisms may underlie early versus late implant failure.

Purpose of the Study:

• To evaluate survival rates of wide-diameter dental implants in a large cohort.
• To identify temporally distinct risk factors for early (≤1 year) and late (>1 year) implant failure.
• To apply landmark analysis for a nuanced understanding of failure predictors.

Main Methods:

• Retrospective cohort study of 12,041 wide-diameter implants in 9,247 patients.
• Implant survival defined as fixture remaining in situ without loss or replacement.
• Kaplan-Meier curves and multivariable Cox models used; landmark analysis at 365 days for time-varying effects.

Main Results:

• Overall implant survival was 97.5% at 5 years.
• Early failures (74.8%) were associated with penicillin allergy, maxillary placement, male sex, and short implant length.
• Late failures (25.2%) were driven by short implant length and kidney disease.

Conclusions:

• Wide-diameter implants demonstrate excellent long-term survival.
• Early failure drivers include perioperative, anatomical, and sex-related factors.
• Late failure drivers are primarily short implant length and renal disease, necessitating targeted surveillance.