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Dental implant removal rates and related factors in older adults in Korea: a cross-sectional study using National Health Insurance Sharing Service database
Hyang-Ah Park, A-Rang Lim, Jae-In Ryu
Epidemiol Health. 2025;47:e2025064.   Published online December 3, 2025
DOI: https://doi.org/10.4178/epih.e2025064
  • 1,482 View
  • 24 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Dental implants have been covered by the National Health Insurance for older adults in Korea since 2014. As the number of implant treatments has increased, the occurrence of related complications has also grown. While many clinical studies have examined mechanical and biological complications, few epidemiological studies using national data have identified population-level risk factors. This study aimed to determine the dental implant removal rate and related factors among older adults based on the Andersen Behavioral Model.
METHODS
A cross-sectional analysis was conducted using the National Health Insurance Service–National Sample Cohort. Logistic regression analyses were performed to identify factors associated with implant removal. Unadjusted and stepwise cumulative models were applied for predisposing, enabling, and need factors. All analyses were conducted using SPSS version 26.0, with statistical significance set at α=0.05.
RESULTS
The overall dental implant removal rate among older adults was approximately 0.4%. Higher removal rates were observed among males, those aged 65-69, current smokers, individuals with diabetes, and the self-employed group with higher income levels. Current smokers had 1.75 times higher odds of implant removal (95% confidence interval, 1.39 to 2.22) than non- smokers or former smokers.
CONCLUSIONS
Targeted education, management, and preventive interventions for high-risk groups, including smokers and patients with diabetes, are necessary to improve implant success and reduce complications. These findings provide population- based evidence to inform public health strategies that promote successful implant outcomes among older adults.
Summary
Korean summary
이 연구는 국가 단위의 빅데이터 코호트를 이용해 치과 임플란트 제거에 관해 시행한 선행 연구가 없었기 때문에 국가 빅데이터를 활용해 치과 임플란트 제거율과 관련 요인을 파악하기 위해 Anderson Model을 기반으로 다요인 분석을 실시하였다. 전체 치과 임플란트 제거율은 약 0.4%였으며, 남성, 젊은 연령, 건강보험 가입자, 상위 소득분위 자영업자, 당뇨병, 흡연, 유산소 신체 활동 실천자에서 더 높게 나타났다. 특히 현재 흡연자인 경우 치과 임플란트 제거율을 경험할 확률이 1.8배 높았다. 따라서, 치과 임플란트 시술의 성공률을 높이기 위해서는 위험요인에 대해 명시한 가이드라인 제작이 필수적이다.
Key Message
This study conducted a multifactorial analysis based on the Andersen model to identify factors associated with dental implant removal using national big data, addressing the lack of prior studies that examined these determinants sufficiently. The dental implant removal rate among all subjects was approximately 0.4%, and higher removal rates were observed among men, younger individuals, those receiving medical benefits, the self-employed group with higher income quintiles, and individuals with diabetes, smoking habits, or engagement in aerobic physical activity. Current smokers had a 1.8-fold higher probability of implant removal. These findings reinforce the importance of developing and implementing guidelines to increase the success rate of dental implants.
The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database
Seon-Rye Kim, Minkook Son, Yu-Rin Kim
Epidemiol Health. 2022;44:e2022055.   Published online July 5, 2022
DOI: https://doi.org/10.4178/epih.e2022055
  • 18,362 View
  • 338 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis.
METHODS
Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index.
RESULTS
In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities.
CONCLUSIONS
Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.
Summary
Korean summary
만성치주질환을 가진 노인에서 스타틴 복용순응도가 낮은 그룹에 비해 높은 그룹이 뇌졸증 발생위험이 낮았다. 특히 여성과 후기 노인 (85세 이상), 동반 질환을 가진 그룹에서 유의한 차이가 있었다. 따라서 스타틴 복용 순응도를 증대시키기 위한 의료진의 노력이 필요할 것이다.
Key Message
The stroke risk of chronic periodontal disease patients was related to statin medication compliance, and the effect of stroke risk was different in women, the elderly, and comorbidities.

Citations

Citations to this article as recorded by  
  • Association between regular dental scaling and stroke risk in patients with periodontal diseases: evidence from a Korean nationwide database
    Yu-Rin Kim, Minkook Son, Seon-Rye Kim
    Epidemiology and Health.2025; 47: e2025020.     CrossRef
  • Association between statin compliance and risk of dementia among patients with chronic periodontitis
    Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
    Oral Diseases.2024; 30(5): 3440.     CrossRef
  • The association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus among the elderly population
    Mohammad-Hossein Heydari, Farshad Sharifi, Shayan Sobhaninejad, Ali Sharifi, Leili Alizadeh, Soheila Darmiani, Shima Bijari, Parvin Parvaie, Soheila Bakhshandeh, Shervan Shoaee, Mohammad-Hossein Khoshnevisan
    Journal of Diabetes & Metabolic Disorders.2024; 23(1): 1371.     CrossRef
  • Impact of statin treatment on cardiovascular events in patients with retinal vein occlusion: a nested case-control study in Korea
    Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim
    Epidemiology and Health.2023; 45: e2023035.     CrossRef
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