Background: Long-term studies of ≥10 years are important milestones to get a better understanding of potential factors causing implant failures or complications.

Purpose: The present study investigated the long-term outcomes of titanium dental implants with a rough, microporous surface (titanium plasma sprayed [TPS]) and the associated biologic and technical complications in partially edentulous patients with fixed dental prostheses over a 20-year follow-up period.

Materials and methods: Sixty-seven patients, who received 95 implants in the 1980s, were examined with well-established clinical and radiographic parameters. Based on these findings, each implant was classified as either successful, surviving, or failed.

Results: Ten implants in nine patients were lost during the observation period, resulting in an implant survival rate of 89.5%. Radiographically, 92% of the implants exhibited crestal bone loss below 1 mm between the 1- and 20-year follow-up examinations. Only 8% yielded peri-implant bone loss of >1 mm and none exhibited severe bone loss of more than 1.8 mm. During the observation period, 19 implants (20%) experienced a biologic complication with suppuration. Of these 19 implants, 13 implants (13.7%) had been treated and were successfully maintained over the 20-year follow-up period. Therefore, the 20-year implant success rate was 75.8 or 89.5% depending on the different success criteria. Technical complications were observed in 32%.

Conclusion: The present study is the first to report satisfactory success rates after 20 years of function of dental implants with a TPS surface in partially edentulous patients.

Keywords: biological complications; crestal bone loss; dental implant; implant success rate; implant survival rate; peri-implant bone loss; prospective follow-up study; technical complications; titanium plasma sprayed.

© 2013 Wiley Periodicals, Inc.