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Does implant placement using a minimally invasive technique increase early failures among trainees at an academic center?

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Abstract

Purpose

This study aims to identify whether dental implants placed using a flapless technique have a higher early failure rate, defined as failure within 6 months of placement, compared to implants placed with flap elevation when a surgical guide is not used.

Methods

A retrospective cohort study was conducted to evaluate implants placed with either flapless (FL) or mucoperiosteal flap (MF) surgery between 2006 and 2012 at the Philadelphia VA Medical Center (PVAMC). Implant status after FL or MF surgery was assessed using dental encounter and radiographs at subsequent follow-up appointments to assess for early implant failures within 6 months of implant placement.

Results

The FL technique was used to place 89 implants in 38 subjects, while the MF technique was used to place 381 implants in 139 subjects. Early failure occurred in 37 implants, of which 13 occurred in the FL group and 24 occurred in the MF group. FL surgery was found to be associated with a 265% increase in early implant failure (OR 2.653; 95% CL 1.287–5.469) and was statistically significant (p = 0.0064). Residents were over 200% more likely to have an early implant failure when using the FL technique (OR 2.314; 95% CL 1.112–4.816),

Conclusions

Analysis revealed flapless implant placement was associated with higher early implant failure rates. In addition, early failures were more likely to occur when residents placed an implant using the flapless technique. While FL surgery can result in long-term success, it is a more technique-sensitive approach that requires greater clinical skill and stricter case selection to perform.

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Data Availability

The datasets used and analyzed during this study are available from the corresponding author on reasonable request.

Code availability

The datasets used and analyzed during this study are available from the corresponding author on reasonable request.

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Acknowledgements

This material is the result of work supported with resources and the use of facilities at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA. The contents do not represent the view of the United States Department of Veterans Affairs or the US Government.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Brian R. Carr & Joseph A. Gulko

  2. Department of Oral and Maxillofacial Surgery, New York University Langone Medical Center and Bellevue Hospital Center, New York, NY, USA

    Peter Rekawek

  3. Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    John F. Coburn

  4. Department of Craniofacial and Oral and Maxillofacial Surgery, Sanford Health, Fargo, ND, USA

    William J. Boggess

  5. Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Sung-Kiang Chuang

  6. Brockton Oral and Maxillofacial Surgery Inc, Brockton, USA

    Sung-Kiang Chuang

  7. Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, MA, USA

    Sung-Kiang Chuang

  8. Penn Presbyterian Hospital, Philadelphia, USA

    Neeraj Panchal

  9. Philadelphia Veteran’s Affairs Medical Center, Philadelphia, USA

    Neeraj Panchal

  10. Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Neeraj Panchal & Brian P. Ford

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  1. Brian R. Carr
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  2. Peter Rekawek
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  8. Brian P. Ford
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Contributions

BC, WB, JG, PR, and JC were major contributors in gathering and organizing the data for the dataset. SC and BC were major contributors in analyzing the dataset. NP and BF oversaw the data collection and data analysis, in addition to helping set up the database. BC was a major contributor in writing the manuscript.

Corresponding author

Correspondence to Brian R. Carr.

Ethics declarations

Ethics approval and consent to participate

This research on dental implants has been approved by Human Studies Subcommittee (IRB I) and all relevant Research & Development (R&D) committees and subcommittees at the Philadelphia Veterans Affairs Medical Center (ID: 01732 Prom#:0001).

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Not applicable.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Carr, B.R., Rekawek, P., Gulko, J.A. et al. Does implant placement using a minimally invasive technique increase early failures among trainees at an academic center?. Oral Maxillofac Surg 27, 245–250 (2023). https://doi.org/10.1007/s10006-022-01057-y

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  • DOI: https://doi.org/10.1007/s10006-022-01057-y

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