Reconstructive Peri-implant Site Development Throughout an Implant Life Cycle: A Retrospective Study.

Purpose: To evaluate the frequency, timing, and financial implication of regenerative hard or soft tissue augmentation procedures (ReP) before and after implant placement, alongside the influence of systemic conditions on the need for additional interventions.

Materials and methods: This cohort included patients who received implants with or without ReP at the University of Michigan Graduate School of Dentistry from 2011 to 2023. Data on demographics and systemic health conditions were collected and analyzed using univariate and multivariate logistic regression.

Results: A total of 4,803 patients (10,247 implants) were included-48.9% of the patients and 21.7% of the implants received at least one ReP, and ancillary ReP was needed for 14.7% of the implants. The most common of these was alveolar ridge augmentation (ARA) simultaneous with implant placement (42.1%) and alveolar ridge preservation (ARP) (26.4%). Patients with diabetes showed significantly higher odds of repeating procedures preoperatively (OR = 5.47; P = .016) and required more frequent hard tissue augmentations after implant placement (OR = 3.58; P = .006). The cost analysis revealed that ReP constituted 12.9% of the total implant procedure cost. Notably, the mandibular anterior area was the most likely to undergo ReP (OR = 2.08; P = .001).

Conclusions: One of every two patients received an ReP, and almost half of these patients received ARA (simultaneous or staged), whereas one-fourth received ARP. Diabetic patients exhibited significantly higher odds of requiring hard tissue augmentation pre-implant site preparation (pre-ISP) and post-implant site preparation (post-ISP). Trends showed a shift toward soft tissue augmentation over hard tissue procedures for managing peri-implant deficiencies.