Failed Osseointegration of Bone-Level Implants at the Sites of Endodontically Failed Mandibular First Molars: A Retrospective Case-Study

Endosseous implants have historically provided functional tooth replacement with predictable success in cases where the structural integrity and longevity of the natural tooth cannot be preserved. However, clinical symptoms mandating immediate implant removal, such as persistent pain and implant mobility, do occur. In order to optimize treatment outcomes, the etiologies and subtleties associated with implant failure should not be ignored. Widely disseminated research has subtly suggested residual biofilms as a conceivable factor in the failure of bone level-implants to osseointegrate. However, very few of these studies specifically theorize about these effects at previously failed endodontic sites. At present, there are three distinguished studies scattered within the literature that explicitly address this idea. The works of both Flanagan (2016) and Prathapachandran (2012) primarily serve as literature reviews that provide specific analyses on the role of microbial biofilms. However, neither work offers novel clinical investigation. The research conducted by Wolff et al. (2017) at the University of Minnesota School of Dentistry appears to provide the only true case-control study focused on patients presenting with both endodontic failure and implant placement (n=47). Nevertheless, the limited sample size and demographics of this study were acknowledged by the researchers to have hindered the statistical power of their results. Ultimately, this retrospective case-study aims to both consolidate present research and underscore the need for further large-scale trials in order to clarify the association of failed endodontic sites and implant failure