Implant-supported restorative therapy in a Swedish population. Complications and cost evaluations

Abstract: Replacing missing teeth through implant-supported restorative therapy is a common treatment procedure. While high survival rates have been reported, complications affecting the implant and/or the implant- supported reconstructions may occur. Such biological or technical complications require additional investment in treatment. The aim of this thesis was (i) to evaluate the occurrence, consequences and possible clustering of implant-related complications, (ii) to assess interventions offered to patients diagnosed with advanced peri- implantitis and (iii) to evaluate costs associated with implant-supported restorative therapy and complications. All evaluations were performed in a Swedish population provided with implant-supported restorative therapy under everyday conditions, and based on analyses of patient records including radiographs. Out of a cohort of 596 subjects, the proportion of patients experiencing technical and/or biological complications over a 9-year period was 42% (Study III). One out of four patients experienced technical complica-tions, chipping being the most common. The extent of restorative therapy was the strongest risk indicator for technical complications (Study I). Patients diagnosed with peri-implantitis (n = 98) rarely received surgical therapy. Non-surgical interventions were insufficient in arresting disease progression (Study II). Accumulated costs during the observation period were significantly higher in patients with full-jaw restorations compared to patients with partial-jaw and single-tooth restorations. Among all complications, implant loss generated the greatest additional costs (Study IV).