Abstract
OBJECTIVES: The purpose of this study was to analyze the survival rate of implants placed in the anterior mandible to evaluate the impact of various prosthetic restoration parameters, including loading protocols, opposing teeth type, prosthesis type, retention type, and cantilever, on implant survival and to evaluate potential risk factors, including systemic disease, associated with implant failure. PATIENTS AND METHODS: : Here, 604 implants installed in the anterior lower jaws of 326 patients that had at least one follow-up visit after prosthetic restoration were included. Implant failure was defined as removal of the implant from the oral cavity. For survival rate analysis, the survival period was defined from the date of implantation to the date of failure or last examination. Survival analysis was conducted using Kaplan-Meier survival curves. Cox regression analysis was performed to identify factors affecting implant survival. RESULTS: Of the 604 implants placed in the mandibular anterior region, 14 failed, a cumulative survival rate of 97.68%. The survival curve varied according to loading method, with immediate loading demonstrating a significantly lower cumulative survival rate compared to early and conventional loading. Survival curves also differed according to retention type, with screw-retained implants having significantly lower cumulative survival than cement-retained and attachment-retained implants. Cantilevered designs also showed significantly reduced cumulative survival compared to non-cantilevered designs. Conventional loading was significantly less likely to fail compared to immediate loading. CONCLUSION: The design of implant-supported prostheses affects the survival of implants placed in the mandibular anterior region. Immediate loading is a risk factor associated with failure of implants in the anterior mandible.