Relationship between Systemic Bone Mineral Density and Local Bone Quality as Effectors of Dental Implant Survival

Purpose: This study aimed to assess (1) the relationship of systemic bone mineral density (BMD) and osteoporotic status with the surgeon's subjective assessment of local jawbone quality, and (2) whether the surgeon's subjective assessment of local jawbone quality is a predictor of implant failure. Materials and Methods: A retrospective analysis of 2,867 dental implants placed in 645 patients was accomplished. The surgeon's assessment of bone quality at the time of dental implant placement was recorded. Of those, 208 patients with 701 implants had BMD data available within 3 years. Statistical analyses were conducted to determine relationships between BMD, osteoporotic status, and local jawbone quality and to determine the relationship between local jawbone quality and implant survival. Results: There was no association between systemic BMD and the surgeon's assessment of bone quality (p = .52) nor between osteoporotic status and the surgeon's assessment of local jawbone quality (Spearman rank correlation coefficient = 0.08). Additional retrospective analysis revealed implants placed in moderate- (hazard ratio = 1.67; p = .043) or poor-quality (HR = 3.45, p < .001) bone (surgeon's assessment) were significantly more likely to fail than implants placed in good-quality bone. Conclusion: Systemic BMD and osteoporotic status are not associated with local jawbone quality. Implants placed in good-quality bone, as assessed subjectively by the surgeon at the time of implant placement, have significantly better survival characteristics than implants placed in moderate-/poor-quality bone.