The problem of missing teeth and edentulous is worldwide. Replacing teeth by dental implant is a successful treatment option. Focus on these factors that enhance the overall success rate of is become important subject. The variation in dental implant geometry, designs and surface texture provided by the manufacturing companies is become important controlling factors on successful treatment.
Objectives: Use variable diameter and length to calculate the success percent of dental implant.
Materials and method: Prospective study involve (680) patients come department of dental implantology in AlRamadi city health center between (May 2007May 2018). 870 easy implant® by French dental implants manufacturer, conical with internal hexagon are used to replace teeth in variety of length and diameter:Max. Central incisor 5×11.5, Max. lateral incisors 5×8.5, Max. canine 5×8.5, Max. 1^{st} premolar 4.3×11, Max. 2^{nd} premolar 4.38, Max. molars 5×7, Mand. central incisors 3.5×10, Mand. lateral incisor 3.5×10.5, Mand. canine 3.5×11.5, Mand. 1^{st} premolar 3.5×8, Mand. 2^{nd} premolar 3.4×8, Mand. molars 4.5×7.
Results: The statistical results indicate that the higher survival rate was (95%) in the Anterior incisors area due standard diameter and length of dental implant. The mean difference is significant at 0.05 level (P<0.05).
Conclusion: Use of standardized diameter, length of dental implant is one factors used to enhance the success rate of this treatment.
success rate, diameter, length, marginal bone loss
The problem of loss of teeth due to extensive caries and periodontal disease is worldwide. Replacement of missing teeth by endosseous implant engage wide use by many dentists other than use fixed bridge and removable denture [1]. Dental implant is that metal component that inserted surgically in jawbone to holed fixed bridge and crown and over dentures. It's act by dissipate force to surrounding bone. Such load affects the stability and survival rate of dental implant [2]. The success rate of dental implant is become very high nowadays due development of new designs, number and load characteristics. The main mechanical benefit from dental implant geometry to dissipate the applied load to periimplant bone [3,4]. The high stress over the bone surrounding dental implant induced by improper transmission of load due to defect in prosthetic appliance, occlusion, dental implant design and also surgical procedures [5]. Other factors like nature of surrounding bone and dental implant materials. The distribution of dental implant in jaw is other factor that affect the stress transmitted over ossteointegrted implant [6]. The used of short dental implant in molar area due mechanical and anatomical limitation [7]. The high occlusal force over the molar teeth in comparison to anterior teeth make size of dental implant of important factor. High force of occlusion also affect the success of ostointegation [8]. Large size of dental implant in molar area affect the thickness of surrounding bone and finally the success of placement of dental implant placed in such high stress area and other problem related to operative skill [9]. Bone quality and height and location of vital anatomical structure in the jaw bones is also other factors to be considered [10]. Wide diameter dental implant is also used as successful replacement of fractured and non osteointegrated implant [11]. For such reason conical shaped threaded implant of various diameters and length has been developed to enhance the survival rate of dental implants [12].
Prospective study involve (680) patients come to AlRamadi health center in department of dental implantology between (May 2007May 2108).820 easy implant® by franch dental implants manufacturer, conical with internal hexagon are used in variety length and diameter:Max. Central incisor 5×11.5, Max. lateral incisors 5×8.5, Max. canine 5×8.5, Max. 1^{st} premolar 4.3×11, Max. 2^{nd} premolar 4.38, Max. molars 5×7, Mand. central incisors 3.5×10, Mand. lateral incisor 3.5×10.5, Mand. canine 3.5×11.5, Mand. 1^{st} premolar 3.5×8, Mand. 2^{nd} premolar 3.4×8, Mand. molars 4.5×7. Patients included in study were selected using specific criteria:patients must be free from systemic diseae, normal blood sugar, good oral health and socioeconomic level. Clinical and radio graphical examination were done before surgery. Dental implant surgery was done under local anesthesia (2% Lidocaine with 80.000 adrenalin). Surgical flap (full thickness) were done by scalpel. Dental implant bed was made using standardized drills of dental implant kit, holes were made in jawbone under continuous irrigation with normal saline. The dental implant was paced and the flap replaced and suture using 3/0 black silk. The dental implant were left in load free period. After 4 months the dental implant were uncovered and gingiva former were placed. After 1week transfer coping were placed and dental impression was taken by alginate. After 1 week the dental appliance were placed. After 1 year the patient were examined clinically, a criterion used for assessment of successful dental implantation are: No pain or tenderness, no mobility, no radiographical bone loss, no pus, no gingival bleeding and no infection. The crestal bone resorption was measured mesially and distally with caliber and the success rate was estimated.
The statistical analysis in below Tables 116 indicate the following (Figures 15).
Table 1. Descriptive statistical table
Diameter 

N 
Mean 
Std. Deviation 
Std. Error 
95% Confidence Interval for Mean 
Minimum 
Maximum 
Lower Bound 
Upper Bound 
Anterior Maxilla 
3 
5.0000 
.00000 
.00000 
5.0000 
5.0000 
5.00 
5.00 
Posterior Maxilla 
3 
4.5333 
.40415 
.23333 
3.5294 
5.5373 
4.30 
5.00 
Anterior Mandible 
3 
3.5000 
.00000 
.00000 
3.5000 
3.5000 
3.50 
3.50 
Posterior Mandible 
3 
3.8333 
.57735 
.33333 
2.3991 
5.2676 
3.50 
4.50 
Total 
12 
4.2167 
.68202 
.19688 
3.7833 
4.6500 
3.50 
5.00 
Table 2. ANOVA test
Diameter 

Sum of Squares 
df 
Mean Square 
F 
Sig. 
Between Groups 
4.123 
3 
1.374 
11.069 
.003 
Within Groups 
.993 
8 
.124 
 
 
Total 
5.117 
11 
 
 
 
Table 3. Multiple comparison table
Dependent Variable: Diameter 
LSD 
(I) Position of dental implant 
(J) Position of dental implant 
Mean Difference (IJ) 
Std. Error 
Sig. 
95% Confidence Interval 
Lower Bound 
Upper Bound 
Anterior Maxilla 
Posterior Maxilla 
.46667 
.28771 
.143 
.1968 
1.1301 
Anterior Mandible 
1.50000^{*} 
.28771 
.001 
.8365 
2.1635 
Posterior Mandible 
1.16667^{*} 
.28771 
.004 
.5032 
1.8301 
Posterior Maxilla 
Anterior Maxilla 
.46667 
.28771 
.143 
1.1301 
.1968 
Anterior Mandible 
1.03333^{*} 
.28771 
.007 
.3699 
1.6968 
Posterior Mandible 
.70000^{*} 
.28771 
.041 
.0365 
1.3635 
Anterior Mandible 
Anterior Maxilla 
1.50000^{*} 
.28771 
.001 
2.1635 
.8365 
Posterior Maxilla 
1.03333^{*} 
.28771 
.007 
1.6968 
.3699 
Posterior Mandible 
.33333 
.28771 
.280 
.9968 
.3301 
Posterior Mandible 
Anterior Maxilla 
1.16667^{*} 
.28771 
.004 
1.8301 
.5032 
Posterior Maxilla 
.70000^{*} 
.28771 
.041 
1.3635 
.0365 
Anterior Mandible 
.33333 
.28771 
.280 
.3301 
.9968 
*The mean difference is significant at the 0.05 level. 
Table 4. Descriptive statistical table
Length 

N 
Mean 
Std. Deviation 
Std. Error 
95% Confidence Interval for Mean 
Minimum 
Maximum 
Lower Bound 
Upper Bound 
Anterior Maxilla 
3 
9.6000 
1.65227 
.95394 
5.4955 
13.7045 
8.50 
11.50 
Posterior Maxilla 
3 
8.6667 
2.08167 
1.20185 
3.4955 
13.8378 
7.00 
11.00 
Anterior Mandible 
3 
10.6667 
.76376 
.44096 
8.7694 
12.5640 
10.00 
11.50 
Posterior Mandible 
3 
7.6667 
.57735 
.33333 
6.2324 
9.1009 
7.00 
8.00 
Total 
12 
9.1500 
1.67250 
.48281 
8.0873 
10.2127 
7.00 
11.50 
Table 5. ANOVA test
Length 

Sum of Squares 
df 
Mean Square 
F 
Sig. 
Between Groups 
14.810 
3 
4.937 
2.475 
.136 
Within Groups 
15.960 
8 
1.995 
 
 
Total 
30.770 
11 
 
 
 
Table 6. Multiple comparison table
Dependent Variable: Length 
LSD 
(I) Position of dental implant 
(J) Position of dental implant 
Mean Difference (IJ) 
Std. Error 
Sig. 
95% Confidence Interval 
Lower Bound 
Upper Bound 
Anterior Maxilla 
Posterior Maxilla 
.93333 
1.15326 
.442 
1.7261 
3.5927 
Anterior Mandible 
1.06667 
1.15326 
.382 
3.7261 
1.5927 
Posterior Mandible 
1.93333 
1.15326 
.132 
.7261 
4.5927 
Posterior Maxilla 
Anterior Maxilla 
.93333 
1.15326 
.442 
3.5927 
1.7261 
Anterior Mandible 
2.00000 
1.15326 
.121 
4.6594 
.6594 
Posterior Mandible 
1.00000 
1.15326 
.411 
1.6594 
3.6594 
Anterior Mandible 
Anterior Maxilla 
1.06667 
1.15326 
.382 
1.5927 
3.7261 
Posterior Maxilla 
2.00000 
1.15326 
.121 
.6594 
4.6594 
Posterior Mandible 
3.00000^{*} 
1.15326 
.032 
.3406 
5.6594 
Posterior Mandible 
Anterior Maxilla 
1.93333 
1.15326 
.132 
4.5927 
.7261 
Posterior Maxilla 
1.00000 
1.15326 
.411 
3.6594 
1.6594 
Anterior Mandible 
3.00000^{*} 
1.15326 
.032 
5.6594 
.3406 
*The mean difference is significant at the 0.05 level. 
Table 7. Correlation test between diameter and length of dental implant

Diameter 
Length 
Diameter 
Pearson Correlation 
1 
.222 
Sig. (2tailed) 
 
.487 
N 
12 
12 
Length 
Pearson Correlation 
.222 
1 
Sig. (2tailed) 
.487 
 
N 
12 
12 
Table 8. Descriptive statistical table
Success% 

N 
Mean 
Std. Deviation 
Std. Error 
95% Confidence Interval for Mean 
Minimum 
Maximum 
Lower Bound 
Upper Bound 
Anterior Maxilla 
3 
94.6667 
.57735 
.33333 
93.2324 
96.1009 
94.00 
95.00 
Posterior Maxilla 
3 
85.0000 
5.00000 
2.88675 
72.5793 
97.4207 
80.00 
90.00 
Anterior Mandible 
3 
92.6667 
2.30940 
1.33333 
86.9298 
98.4035 
90.00 
94.00 
Posterior Mandible 
3 
55.3333 
.28868 
.16667 
54.6162 
56.0504 
55.00 
55.50 
Total 
12 
81.9167 
16.63626 
4.80247 
71.3465 
92.4868 
55.00 
95.00 
Table 9. ANOVA test
Success% 

Sum of Squares 
df 
Mean Square 
F 
Sig. 
Between Groups 
2982.917 
3 
994.306 
129.341 
.000 
Within Groups 
61.500 
8 
7.688 
 
 
Total 
3044.417 
11 
 
 
 
Table 10. Multiple comparison table
Dependent Variable: Success% 
LSD 
(I) Position of dental implant 
(J) Position of dental implant 
Mean Difference (IJ) 
Std. Error 
Sig. 
95% Confidence Interval 
Lower Bound 
Upper Bound 
Anterior Maxilla 
Posterior Maxilla 
9.66667^{*} 
2.26385 
.003 
4.4462 
14.8871 
Anterior Mandible 
2.00000 
2.26385 
.403 
3.2204 
7.2204 
Posterior Mandible 
39.33333^{*} 
2.26385 
.000 
34.1129 
44.5538 
Posterior Maxilla 
Anterior Maxilla 
9.66667^{*} 
2.26385 
.003 
14.8871 
4.4462 
Anterior Mandible 
7.66667^{*} 
2.26385 
.010 
12.8871 
2.4462 
Posterior Mandible 
29.66667^{*} 
2.26385 
.000 
24.4462 
34.8871 
Anterior Mandible 
Anterior Maxilla 
2.00000 
2.26385 
.403 
7.2204 
3.2204 
Posterior Maxilla 
7.66667^{*} 
2.26385 
.010 
2.4462 
12.8871 
Posterior Mandible 
37.33333^{*} 
2.26385 
.000 
32.1129 
42.5538 
Posterior Mandible 
Anterior Maxilla 
39.33333^{*} 
2.26385 
.000 
44.5538 
34.1129 
Posterior Maxilla 
29.66667^{*} 
2.26385 
.000 
34.8871 
24.4462 
Anterior Mandible 
37.33333^{*} 
2.26385 
.000 
42.5538 
32.1129 
*The mean difference is significant at the 0.05 level. 
Table 11. Descriptive statistical table
Failure% 

N 
Mean 
Std. Deviation 
Std. Error 
95% Confidence Interval for Mean 
Minimum 
Maximum 
Lower Bound 
Upper Bound 
Anterior Maxilla 
3 
2.0000 
1.00000 
.57735 
.4841 
4.4841 
1.00 
3.00 
Posterior Maxilla 
3 
5.8667 
.80829 
.46667 
3.8588 
7.8746 
5.00 
6.60 
Anterior Mandible 
3 
4.5000 
.70000 
.40415 
2.7611 
6.2389 
3.70 
5.00 
Posterior Mandible 
3 
12.3333 
.57735 
.33333 
10.8991 
13.7676 
12.00 
13.00 
Total 
12 
6.1750 
4.04208 
1.16685 
3.6068 
8.7432 
1.00 
13.00 
Table 12. ANOVA test
Failure% 

Sum of Squares 
df 
Mean Square 
F 
Sig. 
Between Groups 
174.769 
3 
58.256 
94.088 
.000 
Within Groups 
4.953 
8 
.619 


Total 
179.723 
11 



Table 13. Multiple comparison table
Dependent Variable: Failure% 
LSD 
(I) Position of dental implant 
(J) Position of dental implant 
Mean Difference (IJ) 
Std. Error 
Sig. 
95% Confidence Interval 
Lower Bound 
Upper Bound 
Anterior Maxilla 
Posterior Maxilla 
3.86667^{*} 
.64248 
.000 
5.3482 
2.3851 
Anterior Mandible 
2.50000^{*} 
.64248 
.005 
3.9816 
1.0184 
Posterior Mandible 
10.33333^{*} 
.64248 
.000 
11.8149 
8.8518 
Posterior Maxilla 
Anterior Maxilla 
3.86667^{*} 
.64248 
.000 
2.3851 
5.3482 
Anterior Mandible 
1.36667 
.64248 
.066 
.1149 
2.8482 
Posterior Mandible 
6.46667^{*} 
.64248 
.000 
7.9482 
4.9851 
Anterior Mandible 
Anterior Maxilla 
2.50000^{*} 
.64248 
.005 
1.0184 
3.9816 
Posterior Maxilla 
1.36667 
.64248 
.066 
2.8482 
.1149 
Posterior Mandible 
7.83333^{*} 
.64248 
.000 
9.3149 
6.3518 
Posterior Mandible 
Anterior Maxilla 
10.33333^{*} 
.64248 
.000 
8.8518 
11.8149 
Posterior Maxilla 
6.46667^{*} 
.64248 
.000 
4.9851 
7.9482 
Anterior Mandible 
7.83333^{*} 
.64248 
.000 
6.3518 
9.3149 
*The mean difference is significant at the 0.05 level. 
Table 14. Descriptive statistical table
Marginal bone loss 

N 
Mean 
Std. Deviation 
Std. Error 
95% Confidence Interval for Mean 
Minimum 
Maximum 
Lower Bound 
Upper Bound 
Anterior Maxilla 
3 
.1233 
.00577 
.00333 
.1090 
.1377 
.12 
.13 
Posterior Maxilla 
3 
.4600 
.05292 
.03055 
.3286 
.5914 
.40 
.50 
Anterior Mandible 
3 
.3200 
.01000 
.00577 
.2952 
.3448 
.31 
.33 
Posterior Mandible 
3 
3.6000 
.10000 
.05774 
3.3516 
3.8484 
3.50 
3.70 
Total 
12 
1.1258 
1.49798 
.43243 
.1741 
2.0776 
.12 
3.70 
Table 15. ANOVA test
Marginal bone loss 

Sum of Squares 
df 
Mean Square 
F 
Sig. 
Between Groups 
24.658 
3 
8.219 
2542.023 
.000 
Within Groups 
.026 
8 
.003 
 
 
Total 
24.683 
11 
 
 
 
Table 16. Multiple comparison table
Dependent Variable: Marginal bone loss 
LSD 
(I) Position of dental implant 
(J) Position of dental implant 
Mean Difference (IJ) 
Std. Error 
Sig. 
95% Confidence Interval 
Lower Bound 
Upper Bound 
Anterior Maxilla 
Posterior Maxilla 
.33667^{*} 
.04643 
.000 
.4437 
.2296 
Anterior Mandible 
.19667^{*} 
.04643 
.003 
.3037 
.0896 
Posterior Mandible 
3.47667^{*} 
.04643 
.000 
3.5837 
3.3696 
Posterior Maxilla 
Anterior Maxilla 
.33667^{*} 
.04643 
.000 
.2296 
.4437 
Anterior Mandible 
.14000^{*} 
.04643 
.017 
.0329 
.2471 
Posterior Mandible 
3.14000^{*} 
.04643 
.000 
3.2471 
3.0329 
Anterior Mandible 
Anterior Maxilla 
.19667^{*} 
.04643 
.003 
.0896 
.3037 
Posterior Maxilla 
.14000^{*} 
.04643 
.017 
.2471 
.0329 
Posterior Mandible 
3.28000^{*} 
.04643 
.000 
3.3871 
3.1729 
Posterior Mandible 
Anterior Maxilla 
3.47667^{*} 
.04643 
.000 
3.3696 
3.5837 
Posterior Maxilla 
3.14000^{*} 
.04643 
.000 
3.0329 
3.2471 
Anterior Mandible 
3.28000^{*} 
.04643 
.000 
3.1729 
3.3871 
*The mean difference is significant at the 0.05 level. 
Figure 1. Relation between mean diameter of dental implant and position
Figure 2. Relation between mean length of dental implant and position
Figure 3. Relation between success rate and position of dental implant
Figure 4. Relation between failure rate and position of dental implant
Figure 5. Relation between marginal bone loss and position of dental implant
The statistical analysis in Tables 14 and 15 and Figure 4 indicate that the highest mean value of the mean mesial and distal bone loss was in Posterior Mandibular area was (3.6000±.10000) in comparison with mean mesial and distal bone loss in Anterior Mandibular area (0.3200±.01000). The mean difference is significant at 0.05 level (P<0.05).
Our study was done to estimate the success rate of dental implant using different diameter and length of dental implant placed in different positions. The statistical results of study in Tables 8 and 9 and Figure 2 show survival rate of dental implant in different treated position. The high survival rate of dental implant was in maxillary incisor area (95%) due to use standard size with wide and long dental implant and lower stress area [13,14]. This is also because the large size of dental implant increases the surface area of contact between bone and dental implant and minimize the stress distributed to this area and increase the success of osteointegration. While the lowest survival rate of dental implant was in mandibular molar area (55%) in comparison with other site this due to use of wide size and short for reason related to anatomy and high stress. Statistical result in Tables 1 and 2 and Figure 1 indicate that the higher mean value of diameter of dental implant was in maxillary anterior area (5.000±0.0000). While the lowest mean value was (3.5000±0.000) in anterior mandible. The mean difference is significant at 0.05 level (P<0.05). While the statistical results in Tables 4 and 5 and Figure 2 indicate that the highest mean value of length of dental implant was (10.6667±0.76376) in Anterior Mandible. While the lowest mean value of length of dental implant was in posterior mandible was (7.6667±0.57735) (P>0.05) nonsignificant at 0.05 level. Tables 14 and 15 Figure 5 indicate that the highest mean value of mesial and distal marginal loss was (3.6000±0.10000) in mandibular molar area in comparison with other sites (0.1233±0.00577). The mean difference is significant at 0.05 level (P<0.05) [15,16]. Use of short and large diameter dental implant is instead of bone grafting to avoid the danger of damage to the inferior alveolar nerve and canal and effect of high occlusal load over scares bone and hinder successful ostointegration [17,18]. The difficulty in placing such size is also other factor to be considered in the failure rate of dental implant in these area [19,20]. This is consistent to study conducted Renoaurd who indicate that the failure rate of dental implant increases with short and large diameter, it led to narrow thickness of surrounding bone and also poor skill of dentist [21]. The failure rate of dental implant is increase also due to other factor such as smoking, systemic disease, periodontal condition, surface texture, dental appliance and distribution dental implant through jaw [22]. Studies by Misch indicate that placement of short dental implant<10 mm in posterior molar area associated with high failure rate about 85% after placement of dental appliance [23,24]. But its use has added advantage it minimizes the time required for grating procedures, cost and avoid the postoperative surgical complications and morbidity [25]. Short dental implant in (molar) has complications related to initial stability due less surface contact with bone and interm of stress distribution which hinder successful ossteointgration [26].
Variation in Dental implant geometry provided by many companies to overcome the limitation in use of dental implant in certain area. Large size dental implant increases the area of contact with bone and better distribution of occlusal load which required for osteointergation. This make considerable increases in overall success rate.
Great thank and respect to my family who help me to finish my study.
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