Early Implant Failures Related to Individual Surgeons: An Analysis Covering 11,074 Operations Performed during 28 Years

Background: Compared with knowledge on patient and implant component factors, little knowledge is available on surgeons' role in early implant failures. Purpose: To report incidence of early implant failures related to total number of operations performed by individual surgeons. Materials and Methods: Early implant failures (21 year of implant prosthesis function) were reported after a total of 11,074 implant operations at one specialist clinic during 28 years of surgery. Altogether, 8,808 individual patients were treated by 23 different dentists, of whom 21 surgeons were specialists in oral surgery or periodontology. Recorded failures were related to total numbers of performed operations per surgeon, followed by statistical comparisons (chi(2)) between surgeons with regard to type of treated jaw and implant surface. Results: Altogether, 616 operations were recorded with early implant failures (5.6%), most often observed in edentulous upper jaws after placing implants with a turned surface (p <.05). Significant differences between surgeons, gender of surgeon, type of treated jaws by the surgeon, and implant surface used by the surgeon could be observed (p <.05). Conclusions: Early implant failures are complex, multifactorial problems associated with many aspects in the surgical procedure. A stochastic variation of failures for individual surgeons could be observed over the years. Different levels of failure rate could be observed between the surgeons, occasionally reaching significant levels as a total or for different jaw situations (p <.05). The surgeons reduced their failure rates when using implants with moderately rough surfaces (p <.5), but the relationship of failure rate between the surgeons was maintained.