Clinical Success Rates of Dental Implants with Bone Grafting in a Large-Scale National Dataset

Objective: To evaluate the clinical success outcomes and risk factors associated with dental implants placed with simultaneous bone augmentation in a large-scale, real-world cohort. Methods: A retrospective analysis was conducted on 158,824 implants, including 45,715 Dental Bone Grafts, placed between 2014 and 2022 within a national healthcare network. Multivariate Generalized Estimating Equations were utilized to assess the impact of demographic, anatomical, and procedural variables on implant failure. Results: The augmented cohort demonstrated a high clinical success rate of 97.83% (2.17% failure), statistically comparable to the general implant population. Failures were predominantly early (<1 year), accounting for 70% of losses. Significant independent risk factors included immediate implant placement (3.08% failure vs. 2.07% for delayed), male gender, and maxillary location. Notably, low socioeconomic status (SES) emerged as a significant predictor, with a failure rate of 3.07% compared to 2.06% in high-SES groups. Conclusions: Simultaneous bone augmentation is a predictable modality that does not inherently increase implant failure risk, supporting the stabilization hypothesis. However, failure is modulated by specific variables. The identification of lower SES, male gender, and immediate placement as significant risk indicators highlights the necessity for personalized risk assessment and targeted protocols to optimize outcomes in augmented sites.