What criteria determine success in implant dentistry? A systematic review

This summary is based on the article published in the Journal of Dental Research: Success Criteria in Implant Dentistry: A Systematic Review (March 2012)

P. Papaspyridakos, C.-J. Chen, M. Singh, H.-P. Weber, and G.O. Gallucci

Context

Commonly accepted criteria for the assessment of implant success were proposed to identify clinical evidence of successful osseointegration and survival of implants. (1)

Over the past three decades, implant success has been assessed by survival rates, continuous prosthesis stability, radiographic bone loss, and absence of infection in the peri-implant soft tissues. ( 1 – 6) 

Since then, new parameters have been introduced to assess success in the achieving of lifelike implant restorations: health status and natural-looking peri-implant soft tissues, prosthodontic parameters, esthetics, and patient satisfaction. However, osseointegration remains the predominant parameter in implant dentistry.

It seems logical that the current definition of success criteria should be comprehensive, to include these additional factors. (6 – 9)

Purpose of the Review

The aim of this systematic review is to examine the most frequently used criteria to define treatment success in implant dentistry.

Key Findings

• The criteria for success at the prosthetic level were the occurrence of technical complications/prosthetic maintenance, adequate function, and esthetics during the five-year period. The criteria at patient satisfaction level were discomfort and paresthesia, satisfaction with appearance,
• and ability to chew/taste. Success in implant dentistry should ideally evaluate a long-term primary outcome of an implant-prosthetic complex as a whole.
• The four most frequently used parameters for assessing success were identified through the full-text reading and were related to implant level, peri-implant soft tissue, prosthesis, and patient’s subjective evaluation.
• An attempt to list these parameters in the order of importance seems difficult, because successful osseointegration as the baseline and milestone of implant therapy cannot be directly compared with patient satisfaction, which is equally important.
• Another issue that needs to be addressed is a patient-centered outcome and patient satisfaction with prosthesis. 
• Esthetics is also very important in dentistry, underscoring the necessity for the inclusion of more factors in the success criteria assessment for implant prostheses.

References

1. Albrektsson T, Zarb G, Worthington P, Eriksson AR (1986). The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1:11-25.
2. Smith DE, Zarb GA (1989). Criteria for success of osseointegrated endosseous implants. J Prosthet Dent 62:567-572.
3. Buser D, Weber HP, Lang NP (1990). Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollowcylinder and hollow-screw implants. Clin Oral Implants Res 1:33-40.
4. Albrektsson T, Zarb GA (1998). Determinants of correct clinical reporting. Int J Prosthodont 11:517-521.
5. Misch CE, Perel ML, Wang HL, Sammartino G, Galindo-Moreno P, Trisi P, et al. (2008). Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent 17:5-15.
6. Annibali S, Bignozzi I, La Monaca G, Cristalli MP (2009). Usefulness of the aesthetic result as a success criterion for implant therapy: a review. Clin Implant Dent Relat Res [epub ahead of print Aug 6, 2009] (in press).
7. Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G (2005). Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res 16: 639-644.
8. Meijer HJ, Stellingsma K, Meijndert L, Raghoebar GM (2005). A new index for rating aesthetics of implant-supported single crowns and adjacent soft tissues—the Implant Crown Aesthetic Index. Clin Oral Implants Res 16:645-649.
9. Belser UC, Grutter L, Vailati F, Bornstein MM, Weber HP, Buser D (2009). Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol 80:140-151.

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