Caponio Vito Carlo Alberto, Sharma Ajay, Musella Gennaro, Perrotti Vittoria, Quaranta Alessandro
Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
School of Dentistry and Oral Health, Griffith University, Southport, QLD, Australia.
J Dent. 2025 Feb;153:105531. doi: 10.1016/j.jdent.2024.105531. Epub 2024 Dec 15.
Dental implant treatment can still fail due to various factors. The aim of this retrospective cohort study was to assess the influence of operator experience in a postgraduate educational setting, as well as patient, implant, and surgical risk factors on the incidence of the dental implant failure.
The dental records of 1049 implants with a mean follow-up of 794.70 days were analysed. Variables included operator experience (year of specialty study) and clinic-pathological patients' related variables. Clinic-pathological associations were explored and a Cox regression model accounted for implant survival factors.
Multivariate analysis revealed that a history of periodontitis and smoking were the only factors with independent prognostic value, with hazard ratios of 2.0 (95 % CI: 1.0-4.0, p = 0.048) and 1.9 (95 % CI: 1.0-3.6, p = 0.039) respectively. Conversely, despite implant treatment delivered by early career students had a higher failure rate (5.6 %) compared to advanced career students (3.7 %), this difference was statistically significant only in the univariate analysis.
Periodontitis and smoking are independent prognostic variables, with career level potentially biasing complex case allocation to advanced students. Targeted educational interventions, including virtual reality and artificial intelligence, should be emphasized in student training. University-based implant trials must consider operator career stage.
The study underscores the importance of operator experience in dental implant success. It highlights that while clinical experience influences outcomes, factors like a history of periodontitis and smoking are independent predictors of implant failure. These findings emphasize the need for targeted educational interventions to improve clinical training and patient outcomes.
由于各种因素，牙种植治疗仍可能失败。这项回顾性队列研究的目的是评估研究生教育环境中操作者经验以及患者、种植体和手术风险因素对牙种植失败发生率的影响。
分析了1049颗种植体的牙科记录，平均随访794.70天。变量包括操作者经验（专科学习年限）和临床病理患者相关变量。探讨了临床病理关联，并采用Cox回归模型分析种植体存活因素。
多变量分析显示，牙周炎病史和吸烟是仅有的具有独立预后价值的因素，风险比分别为2.0（95%CI：1.0 - 4.0，p = 0.048）和1.9（95%CI：1.0 - 3.6，p = 0.039）。相反，尽管早期职业生涯学生进行的种植治疗失败率（5.6%）高于晚期职业生涯学生（3.7%），但这种差异仅在单变量分析中具有统计学意义。
牙周炎和吸烟是独立的预后变量，职业水平可能会使复杂病例分配偏向高年级学生。在学生培训中应强调针对性的教育干预措施，包括虚拟现实和人工智能。基于大学的种植试验必须考虑操作者的职业阶段。
该研究强调了操作者经验对牙种植成功的重要性。它突出表明，虽然临床经验会影响治疗结果，但牙周炎病史和吸烟等因素是种植失败的独立预测因素。这些发现强调了需要采取针对性的教育干预措施来改善临床培训和患者治疗结果。
