Implant Selection Patterns and Associated Clinical Determinants in Full-Mouth Rehabilitation: A Retrospective Cohort...

Implant-supported full-mouth rehabilitation is a predictable treatment modality for managing edentulous patients. Appropriate implant selection, particularly implant diameter, is influenced by several patient-, site-, implant-, and prosthetic-related factors. However, limited evidence is available regarding the clinical determinants that guide implant selection patterns in routine full-mouth rehabilitation. This study aimed to evaluate implant selection patterns in full-mouth rehabilitation and identify factors associated with the selection of wide-diameter implants.

This retrospective study reviewed the records of patients who underwent implant-supported full-mouth rehabilitation between January 2016 and December 2022. Data on patient demographics, smoking status, systemic health, jaw location, implant region, bone quality, bone augmentation, implant dimensions, implant characteristics, prosthetic design, and loading protocol were collected. The primary outcome was the selection of wide-diameter implants (≥4.5 mm). Descriptive statistics were calculated, and associations between variables and implant diameter categories were assessed using chi-square and independent-samples t-tests. Generalized estimating equations (GEE) were used to identify independent predictors while accounting for the clustering of arches within patients. Statistical significance was set at p < 0.05.

A total of 178 patients contributed to 250 rehabilitated arches. Wide-diameter implants were selected for 43 (17.2%) arches, whereas non-wide-diameter implants were used for 207 (82.8%) arches. Wide-diameter implant selection was significantly associated with mandibular arches (p = 0.004), posterior implant regions (p = 0.001), poor bone quality (p < 0.001), bone augmentation procedures (p < 0.001), greater implant length (12.3 ± 2.1 mm; p = 0.002), fixed full-arch prostheses (p = 0.018), and loading protocols (p = 0.012). Multivariable GEE analysis identified bone augmentation (adjusted odds ratio (aOR) = 3.12, p < 0.001), poor bone quality (aOR = 2.64, p < 0.001), posterior implant region (aOR = 2.18, p < 0.001), mandibular arch (aOR = 1.87, p = 0.010), smoking (aOR = 1.88, p = 0.024), fixed full-arch prosthesis (aOR = 1.74, p = 0.039), and increasing age (aOR = 1.03, p = 0.046) as independent predictors of wide-diameter implant selection.

Implant selection for full-mouth rehabilitation is influenced by multiple anatomical, biological, and prosthetic factors. Bone augmentation, poor bone quality, posterior implant location, mandibular arch placement, smoking status, fixed full-arch prosthetic design, and increasing age were independently associated with wide-diameter implant selection, highlighting the importance of individualized treatment planning for implant-supported rehabilitation.