Risk of Late Implant Loss and Peri-Implantitis Based on Dental Implant Surfaces and Abutment Types: A Nationwide Cohort Study in the Elderly

Abstract

Aim: This nationwide population-based cohort study aimed to assess the incidence of implant complication treatments, including implant removal procedures and peri-implantitis treatments, in relation to implant surfaces and abutment types. Methods: Data from the National Health Insurance Service, covering approximately 50 million individuals, were used. Implants and abutments were categorized by codes, including surfaces such as resorbable blasting media, sandblasted large grit and acid-etched (SA) and hydroxyapatite coating, along with abutment structures (one-piece straight, two-piece straight, angled). The incidence of implant complication treatments was analysed using Kaplan-Meier curves and Cox proportional hazards regression (alpha = 0.05). Results: The study included 2,354,706 implants. The SA group had the lowest hazard ratio for implant removal procedures (p < 0.0001). No significant differences were found in the risk of peri-implantitis treatments between implant surfaces (p = 0.0587). The risk of implant complication treatments did not differ significantly by the abutment type (p = 0.9542). The incidence rate of implant complication treatments was < 3.9 per 1000 implant-years across all groups. Conclusions: The SA group showed a slightly lower risk of late implant loss, whereas no significant association was found for the abutment type groups. All implant and abutment type groups showed an incidence rate of < 3.9 per 1000 implant-years for complication treatments.