Factors Related to Success and Failure Rates at 3-Year Follow-up in a Multicenter Study of Overdentures Supported by Brånemark Implants
John E. Hutton, DDS, MS, MPH/M. Robin Heath, PhD, BDS, FDSRCS/ John Y. Chai, BDS, MS/Joseph Harnett, DDS/Torsten Jemt, DDS, PhD/ Richard B. Johns, PhD, LDSRCS/Samuel McKenna, DDS, MD/ David C. McNamara, BDSc, MDS, PhD/ Daniel van Steenberghe, MD, PhD/ Ross Taylor, BDS, MDS/ Roger M. Watson, BDS, MDS, FDSRCS/ Irene Herrmann, DDS
An international prospective study of Brånemark implants retaining overdentures was conducted at nine clinical centers. One hundred thirty-three subjects were recruited in a 12-month period and provided with 510 implants, 117 of which were in maxillae and 393 were in mandibles. This study reports the 3-year follow-up status of 120 overdentures and 444 implants. There were 11 overdenture failures (9.2%). Maxillary overdenture failure rates (27.6%) were nearly nine times greater than mandibular overdenture failure rates (3.3%). Maxillary overdenture treatment was less successful than previously reported fixed implant-supported restorations. However, their mandibular counterparts had success rates slightly higher than those reported for fixed implant-supported restorations. At 3 years, 150 implants remained submerged and 66 implants had been withdrawn because the subjects discontinued study participation. Eleven mandibular and 29 maxillary implants had failed and had been removed from 21 subjects. Logistic regression with forward model selection indicated that one two-way interaction was significantly related to implant failure. At highest risk were the subjects who possessed dental arches with bone quantity E and bone quality 4. Subjects with one implant failure were likely to have more than one failure. The Generalized Estimating Equation was used to adjust for the cluster effect in this population because multiple implants (2 to 6) were placed and evaluated in each of the 133 subjects.
Key words: Brånemark implants, multicenter study, overdentures