Comparison of Pre-prosthetic Implant Complication Between Obese and Non-obese Patients

Objectives: To compare the occurrence of implant failure and complications between obese and non-obese patients using Body Mass Index (BMI) as a measure of total body fat.
Methods: The CWRU Dental School database was searched for patients with implants placed between 2008 and 2012. The study sample included 220 patients with 321 implants equally distributed between maxilla and mandible. BMI was calculated from self-reported height and weight. Patients were classified as normal (BMI, 18.5-24.5kg/m²), overweight (BMI, 25-29.9kg/m²) or obese (BMI ≥30kg/m²). Failure was defined as implants that did not osseointegrate. Complications included infection, inflammation and bone loss prior to implant restorative procedures. Covariates included age, gender, smoking(Y/N), diabetes(Y/N) and periodontal condition(none/mild Vs. moderate/severe). Patient level analysis of implant complication(Y/N) was conducted using logistic regression.
Results: Total proportion of failed implants was (7/321 or 2.1%) and did not differ by the BMI category. Twenty-seven patients had an implant that experienced at least one pre-prosthetic complication. Only BMI category was significantly associated with the presence of implant complications (p=.037). Compared to patients with normal BMI, both overweight (OR=3.07, p=.08) and obese patients (OR=4.52, p=.02) had increased odds of experiencing an implant complication after adjustment for all covariates. Diabetics were associated with decreased odds of experiencing implants complications when compared to non-diabetics(OR=.61, p=.54).
Conclusions: No association was observed between obesity and implant failure; however, being obese was more often associated with implant complications. Care protocols for diabetic patients may be responsible for obese diabetics not experiencing more implant complications and may be clinically useful for obese patients.