Assessment of surgical complications related to dental implant surgery using Clavien-Dindo Classification

Year 2021, Volume: 8 Issue: 3, 679 - 684, 31.12.2021

Emrah Dilaver , Kıvanç Berke Ak , Muazzez Suzen , Sina Uçkan

https://doi.org/10.15311/selcukdentj.765632

Abstract

Background: The aim of this study is to evaluate the surgical complications encountered in the implants made by the same surgeon between 2016-2019 using the Clavien-Dindo classification used to grade the severity of surgical complications Methods: This retrospective study includes a total of 1171 implants performed in 368 cases undergoing dental implant surgery. Complications related to the operation were recorded and these complications were evaluated according to the Clavien-Dindo Classification system. Possible effects of other factors such as age, gender, smoking, Diabetes mellitus and immediate implant placement on complications were also evaluated . Results: A total of 98 complications have been reported, including flap dehiscence, numbness, infection, the apical part of the dental implant in the maxillary sinus, lack of primary stability, and cortical bone perforation. Smoking and immediate implantation were found to be risk factors for flap dehiscence (p <0.05). 54.8% of the complications were in Clavien-Dindo Class I and 28.5% in Class IIIa. According to the Clavien-Dindo classification, gender, age, smoking and Diabetes Mellitus did not increase the severity of the complications encountered. Conclusion: The Clavien-Dindo classification could serve as a useful in dental implant surgery both for standardization of complications and to help clinicians understand the consequences of complications. Wide range of using the Clavien-Dindo classification system would allow comparisons of different techniques’ outcome in implant surgery among different surgeons and centers.

Keywords

Clavien-Dindo classification, surgery complications, dental implant surgery

References

• [1] Givol N, Chaushu G, Halamish-Shani T, Taicher S. Emergency Tracheostomy Following Life-Threatening Hemorrhage in the Floor of the Mouth During Immediate Implant Placement in the Mandibular Canine Region. J Periodontol 2000;71:1893–5.
• [2] Pelayo JL, Diago MP, Bowen EM, Diago MP. Intraoperative complications during oral implantology. Med Oral Patol Oral Cir Bucal 2008;13:239–43.
• [3] Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants: A systematic review and meta-analysis. J Dent 2015;43:487–98.
• [4] Alberto Monje, Andres Catena WSB. Association between Diabetes Mellitus/Hyperglycemia and Peri-Implant Diseases: Systematic Review and Meta-Analysis. Int J Lab Hematol 2016;38:42–9.
• [5] Clavien PA, Barkun J, De Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The clavien-dindo classification of surgical complications: Five-year experience. Ann Surg 2009.
• [6] Bolliger M, Kroehnert JA, Molineus F, Kandioler D, Schindl M, Riss P. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg - Acta Chir Austriaca 2018;50:256–61.
• [7] Castellanos-Cosano L, Rodriguez-Perez A, Spinato S, Wainwright M, Machuca-Portillo G, Serrera-Figallo MA, et al. Descriptive retrospective study analyzing relevant factors related to dental implant failure. Med Oral Patol Oral y Cir Bucal 2019;24:e726–38.
• [8] Annibali S, Ripari M, LA Monaca G, Tonoli F, Cristalli MP. Local complications in dental implant surgery: prevention and treatment. Oral Implantol (Rome) 2008;1:21–33.
• [9] Resnik R, Misch CE. Misch’s avoiding complications in oral implantology. 1st Editio. 2017.
• [10] Jasim Al-Juboori M, Carlos Magno Filho L, Mohammed Jasim Al-Juboori C, Carlos L. The influence of flap design and technique on dental implant success, prognosis and morbidity: Mini review. Int J Contemp Dent Med Rev 2015;2015:4–7.
• [11] Sadig W, Almas K. Risk factors and management of dehiscent wounds in implant dentistry. Implant Dent 2004;13:140–7.
• [12] Jung JH, Choi BH, Zhu SJ, Lee SH, Huh JY, You TM, et al. The effects of exposing dental implants to the maxillary sinus cavity on sinus complications. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology 2006;102:602–5.
• [13] Kim JS, Choi SM, Yoon JH, Lee EJ, Yoon J, Kwon SH, et al. What Affects Postoperative Sinusitis and Implant Failure after Dental Implant: A Meta-analysis. Otolaryngol - Head Neck Surg (United States) 2019;160:974–84.
• [14] Lin CS, Wu SY, Huang HY, Lai YL. Systematic review and meta-analysis on incidence of altered sensation of mandibular implant surgery. PLoS One 2016;11:1–19.
• [15] Steinberg MJ, Kelly PD. Implant-related Nerve Injuries. Dent Clin North Am 2015;59:357–73.
• [16] Braun RS, Chambrone L, Khouly I. Prophylactic antibiotic regimens in dental implant failure: A systematic review and meta-analysis. J Am Dent Assoc 2019;150:e61–91.
• [17] Lafaurie GI, Sabogal MA, Castillo DM, Rincón MV, Gómez LA, Lesmes YA, et al. Microbiome and Microbial Biofilm Profiles of Peri-Implantitis: A Systematic Review. J Periodontol 2017;88:1066–89.
• [18] Veitz-Keenan A, Ferraiolo DM, Keenan JR. Impact of asepsis technique on implant success. A review. Eur J Oral Implantol 2018;11 Suppl 1:S113–21.
• [19] Gill AS, Morrissey H, Rahman A. A systematic review and meta-analysis evaluating antibiotic prophylaxis in dental implants and extraction procedures. Med 2018;54:1–27.
• [20] Lambert PM, Morris HF, Ochi S. The influence of 0.12% chlorhexidine digluconate rinses on the incidence of infectious complications and implant success. J Oral Maxillofac Surg 1997;55:25–30.
• [21] Martin A, Komada MR, Sane DC. Abnormal angiogenesis in diabetes mellitus. Med Res Rev 2003;23:117–45.
• [22] Ekmektzoglou KA, Zografos GC. A concomitant review of the effects of diabetes mellitus and hypothyroidism in wound healing. World J Gastroenterol 2006;12:2721–9.
• [23] Broughton G, Janis JE, Attinger CE. Wound healing: An overview. Plast Reconstr Surg 2006;117:1–32.
• [24] Anner R, Grossmann Y, Anner Y, Levin L. Smoking, diabetes mellitus, periodontitis, and supportive periodontal treatment as factors associated with dental implant survival: A long-term retrospective evaluation of patients followed for up to 10 years. Implant Dent 2010;19:57–64.
• [25] Wu X, Al-Abedalla K, Eimar H, Arekunnath Madathil S, Abi-Nader S, Daniel NG, et al. Antihypertensive Medications and the Survival Rate of Osseointegrated Dental Implants: A Cohort Study. Clin Implant Dent Relat Res 2016;18:1171–82.
• [26] Jones JK, Triplett RG. The relationship of cigarette smoking to impaired intraoral wound healing: a review of evidence and implications for patient care. J Oral Maxillofac Surg 1992;50:237–9; discussion 239-40..