Dental implant failures in Utah and US veteran cohorts

• Published in: Clinical implant dentistry and related research Vol. 26; no. 3; pp. 604 - 614
• Main Authors: Miller, Aaron John, Brown, Layne Clair, Wei, Guo, Durham, Mark Richards, Hulet, Forest Norton, Jeyapalina, Sujee, Stoddard, Greg, Griffin, Alec Scott
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.06.2024; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Cohort Studies; Confidence intervals; Data analysis; dental care; Dental implants; Dental Implants - statistics & numerical data; Dental prosthetics; Dental Restoration Failure - statistics & numerical data; edentulous; Electronic health records; Electronic Health Records - statistics & numerical data; Electronic medical records; Failure; Failure rates; Female; Humans; Male; Middle Aged; mouth; peri‐implantitis; Regression analysis; Regression models; Risk management; Risk reduction; Statistical analysis; United States; United States Department of Veterans Affairs - statistics & numerical data; Utah; veteran; Veterans; Veterans - statistics & numerical data; veterans' electronic health record; United States; Utah; United States > US; mouth; veterans' electronic health record; edentulous; veteran; dental care; peri‐implantitis; dental implants
• ISSN: 1523-0899; 1708-8208; 1708-8208
• DOI: 10.1111/cid.13320

Introduction Approximately, 5.5 million dental implants are estimated to be surgically placed in the United States yearly, with an anticipated long‐term failure rate ranging from 3% to 10%. At the Salt Lake City Dental Clinic within the Department of Veterans Affairs (VHA), specific protocols have been established to mandate that clinicians present every dental implant case for review by a committee. To understand the effectiveness of this approach, a comparative data analysis was undertaken to compare local dental implant failure data against national VHA data. Methods Leveraging electronic health records of veterans spanning from 2000 to 2021, we gathered procedural records related to dental implant placement or failure, demographic information, and medical history for individuals who received dental care at various dental clinics within the nationwide VHA network. Subsequently, statistical analyses were conducted using mixed‐effects Poisson regression models with cluster‐robust standard errors. Incident rate ratios (IRRs) for Utah‐specific and nationwide cohorts were ascertained. Results The Utah VHA dental clinical data showed that there was a slightly lower prevalence of implant failure at 6.7% compared to the national cohort, which had a rate of 6.9%. The implant level failure rates were also low, with 4.20 (confidence interval [CI]: 3.68, 4.81) per 1000 implant placements per year for Utah cohorts. The adjusted IRR indicated a relative 16% reduction in risk among Utah Veterans (IRR 0.84, 95% CI [0.76–0.92]; p < 0.001). Conclusions The stringent protocols in place at Salt Lake City, which integrate evidence‐based practices and expert opinion for evaluating patient suitability for dental implant placement and subsequent care, contributed to the reduced risk among Utah Dental Clinic veterans pool compared to veterans of other states.