Re: Failed Apicoectomy?

robertphillips1820@xxxxxxxxxxx wrote:
However, some of the new bromides I hear, such as "an implant will last 30 years at least, >but a fixed bridge only lasts 10 years"


I still feel that insufficient advice is given about possibility of
implant failure, and the subject of long-term failure rates is not
sufficiently aired in the public domain. These days, a patient may
find plenty of information on the Internet about implants as a
restorative option, but almost nothing about their failures, or
consequences when this happens in the longer-term. I've discovered
that almost all consultants are reluctant to talk about this, which
leads me to suspect that implants do not generally have the life
expectancy that's claimed.




I hate to be cynical (though that's my natural inclination ;-)).
The first time I heard these 95% success rates badied about was at some lectures on Branemark over 20 years ago (maybe more). I don't know when Per started placing these babies in Goteborg, but it does beg the issue as to just what "long-term" success meant. I think they had at least 10 years at that time, perhaps 15. Certainly this is very, very good, and he was showing high success. But it was always (to me, anyway) a little bit fuzzy as to what the criteria for success was. These early restorations--usually the "high watermark" prostheses were built with a large safety factor--that is, a lot of fixtures were placed. Sometimes the success rates quoted were for the full restoration--ie: was the prosthesis still functioning in the mouth at the end of 10, 15 years etc. Usually (if memory serves) the success rates were NOT being quoted for the individual fixture, and where they were the success rates were significantly lower (though still good).
Of course, gross success rates aren't too meaningful in an individual situation. A well-placed implant in the lower premolar region is likely to do better than an upper molar with a sinus lift and type 4 bone.
In any case, I'm fairly new to restoring implants (maybe 5 years?) and yes, I've seen a significant number of failures. I don't have any way of knowing that my experience is representative. It just seems to me that implant prosthesis should be presented as one very important new modality at our disposal for restoring a patient to function, and not a new paradigm that sweeps that last 200 years of dental prosthesis into the dustbin of history.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

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