Dental implants succeed equally well in sites scarred by previous tooth damage
A Swedish registry study of over 1,200 patients found that dental implants placed where teeth had previously resorbed survived at rates comparable to—and even slightly better than—implants in unaffected sites. The finding could reshape patient counseling and expand the pool of candidates considered suitable for implant surgery.
Originaltitel: Survival of single-tooth implants in sites with and without history of external cervical root resorption: a register-based cohort study
Tandimplantat fungerar lika bra även på tänder som tidigare drabbats av extern cervikal rotresorption (ECRR). Svenska forskare följde 605 matchade implantatpar (2009–2022) från Västra Götaland och analyserade överlevnadsdata från Nationella Tandvårdsregistret. Efter tio år var överlevnaden 97,3 procent för implantat på ECRR-platser respektive 94,4 procent på opåverkade platser — en skillnad som inte var statistiskt signifikant. Endast två procent av implantat på ECRR-platser måste extraheras jämfört med 3,7 procent i kontrollgruppen. Studien inkluderade främst framtänder i överkäken hos patienter med medelålder 52 år. För inköpschefer och tandvårdssamordnare underlättar resultaten beslutsfattningen vid implantatval — ECRR-anamnesen behöver inte längre få samma tyngd i riskbedömningen. Begränsningen är registerdatans natur och lågt antal implantatförluster.
Abstract Purpose To compare the survival of single-tooth implants placed in sites with previous external cervical root resorption (ECRR) to those placed in unaffected sites. Methods A retrospective matched cohort study was conducted using data from the Swedish National Dental Health Register (2009–2022). Patients receiving a single-tooth implant in a site with previous ECRR were identified and matched 1:1 to controls without such history by age, sex, tooth position, and timing of implant placement (± 2 years). Implant survival, defined as time from placement to removal, was analyzed using Kaplan–Meier curves and stratified Cox proportional hazards models. Restricted mean survival time (RMST) was estimated up to 10 years. Subgroup and sensitivity analyses assessed robustness. Results The final cohort included 605 matched pairs ( n = 1,210). The mean age was 52 years, and 56% of implants were placed in the maxillary anterior region. Implant extraction occurred in 12/571 (2.1%) sites with previous ECRR and 21/564 (3.7%) control sites. Ten-year cumulative survival was 97.3% for sites with previous ECRR and 94.4% for controls. The difference was not statistically significant ( HR = 0.58; 95% CI : 0.28–1.22; p = 0.15). RMST analysis showed a negligible absolute survival difference (0.11 years; 95% CI : −0.04 to 0.25; p = 0.15). Conclusions Within the limitations of registry-based data and a low number of failures, no statistically significant difference in implant survival was detected between sites with and without previous ECRR. These findings suggest comparable survival outcomes but should be interpreted with caution.