# Association Between the Type of Dental Care Setting and the Risk of Dental Implant Failure in Korea: A Retrospective Nationwide Population-Based Cohort Study

## TL;DR

This study found that dental implant failures are more common in private dental practices compared to hospital-based clinics in Korea.

## Contribution

The study identifies a significant association between dental care setting and implant failure risk using nationwide data in Korea.

## Key findings

- Hospital-based dental clinics had a 66% lower risk of implant failure compared to private practices.
- Private practices with high procedural volume had a higher failure risk than those with lower volume.
- The study suggests the need for improved postoperative care in high-risk settings.

## Abstract

In Korea, the introduction of reimbursable dental implant procedures has intensified competition among dental practices, albeit with an increase in consumer complaints related to implant failures. Our study aimed to evaluate the association between the dental implant failure risk and the dental care setting.

This retrospective cohort study used data from the Health Screening Cohort (HEALS) of the Korean National Health Insurance Service (NHIS) to analyze the risk of dental implant failure from January 1, 2016, to December 31, 2019. The risk of dental implant failure according to the dental care setting was assessed using inverse probability of treatment weighting (IPTW) adjusted Cox regression analysis. The covariates included demographic, socioeconomic, and clinical factors. The hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated. Among 44 220 cases, additional analyses were performed by stratifying implant procedures in private dental practice (n = 40 502) into quartiles to assess the risk of failure according to procedural volume.

Hospital-based dental clinics exhibited a lower implant failure risk compared with private dental practices (HR: 0.35, 95% CIs: 0.30–0.41) and group dental practices (HR: 0.34, 95% CIs: 0.20–0.58). Private dental practices with the top 10% and 5% procedural volume showed a higher failure risk (HR: 1.23, 95% CIs: 1.09–1.38; HR: 1.38, 95% CIs: 1.23–1.54, respectively) relative to practices handling the remaining 90% and 95%.

The risk of dental implant failure was lower in hospital-based dental clinics compared with private and group dental practices, indicating the need for more systematic and thorough postoperative care to improve implant safety in settings associated with higher failure risk.